1. Home
  2. Directory
  3. Louisiana
  4. Shreveport
  5. Clinic Center
  6. NPI Profile

MAGNOLIA REHABILITATION SERVICES INC
NPI 1881691194
Clinic/Center - Multi-Specialty in Shreveport, LA

Active since June 30, 2005
4005 LAKESHORE DR, SHREVEPORT, LA 71109(337) 324-8465(318) 676-3083 Get Directions Write a Review

NPPES record last updated: June 4, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 4, 2025, Feb 5, 2025 (2 updates tracked since 2025).

About Magnolia Rehabilitation Services Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAGNOLIA REHABILITATION SERVICES INC (NPI 1881691194) is a healthcare organization registered as a multi-specialty in Shreveport, Louisiana and active in the NPI registry since June 2005. The organization maintains a secondary practice location in Paterson and lists Dewarrent Lee Brantley, Owner/ceo, as its authorized official.

NPPES Registry Identity

NPI1881691194
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameMAGNOLIA REHABILITATION SERVICES INC
Location Address4005 LAKESHORE DRShreveport, LA 71109-1927
Mailing Address4005 Lakeshore DrShreveport, LA 71109-1927 · (318) 840-9074 · Fax (318) 860-3025
Phone(337) 324-8465
Fax(318) 676-3083
Organization SubpartNo
Authorized OfficialDewarrent Lee BrantleyOwner/ceo · (318) 840-9074
Enumeration DateJune 30, 2005
Last NPPES UpdateJune 4, 20252 updates tracked since enumeration
NPPES CertifiedJune 4, 2025
✔ NPI 1881691194 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
License✔ Licensed in LA · 5CF64
Also ListedClinic/CenterTaxonomy 261Q00000X
4005 LAKESHORE DR, Shreveport, LA 71109
Open in Google Maps ↗

Secondary Practice Location 1

Location 1680 Broadway Ste 68Paterson, NJ 07514-1524 · Phone (318) 840-9074

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Magnolia Rehabilitation Services Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Magnolia Rehabilitation Services Inc, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Darlinda Dove, FNP
Nurse Practitioner
NPI 1003329871
1109 7TH AVE
Glenmora, LA 71433
(318) 579-8019
✔ PECOS✔ Accepts Medicare126 mi
Steve Odeh, M.D
Vascular Surgery
NPI 1801940200
509 ALABAMA AVE S
Bremen, GA 30110
(770) 537-5555
✔ PECOS✔ Accepts Medicare510 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Magnolia Rehabilitation Services Inc's NPI number?

The NPI number for Magnolia Rehabilitation Services Inc is 1881691194. It was assigned to this organization in the NPPES registry on June 30, 2005.

Where is Magnolia Rehabilitation Services Inc located?

Magnolia Rehabilitation Services Inc is located at 4005 Lakeshore Dr, Shreveport, LA 71109. The listed phone number is (337) 324-8465.

What is Magnolia Rehabilitation Services Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Is Magnolia Rehabilitation Services Inc enrolled in Medicare?

Yes. Magnolia Rehabilitation Services Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Magnolia Rehabilitation Services Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Magnolia Rehabilitation Services Inc, in Nurse Practitioner and Vascular Surgery. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Magnolia Rehabilitation Services Inc was last updated on June 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.