GINA YI INTHAVONG NURSE PRACTITIONER
NPI 1912579301
Nurse Practitioner in Shreveport, LA

Q: What is Gina Inthavong's NPI number?

The NPI number for Gina Inthavong is 1912579301. It was assigned to this individual provider in the NPPES registry on July 14, 2021.

Q: What is Gina Inthavong's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Gina Inthavong was last updated on July 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.

Active since July 14, 2021PECOS EnrolledAccepts Medicare Assignment

80.02/100

CMS Quality Rating

1800 BUCKNER ST STE C120, SHREVEPORT, LA 71101(318) 227-8899(318) 425-3793 Get Directions Write a Review

NPPES record last updated: July 14, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Gina Yi Inthavong Nurse Practitioner NPPES

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

GINA YI INTHAVONG NURSE PRACTITIONER (NPI 1912579301) is an individual nurse practitioner in Shreveport, Louisiana, licensed in Louisiana (221149) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS, is affiliated with Willis Knighton Medical Center, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1912579301

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameGINA YI INTHAVONGCredential: NURSE PRACTITIONER

Location Address1800 BUCKNER ST STE C120Shreveport, LA 71101-4453

Mailing Address1800 Buckner St Ste C120Shreveport, LA 71101-4453 · (318) 227-8899 · Fax (318) 425-3793

Phone(318) 227-8899

Fax(318) 425-3793

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateJuly 14, 2021

NPPES CertifiedJuly 14, 2021

✔ NPI 1912579301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in LA · 221149

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

1800 BUCKNER ST STE C120, Shreveport, LA 71101

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gina Yi Inthavong Nurse Practitioner is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2264839380

PECOS Enrollment IDI20210916000499, I20251001002950

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

145 services141 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

59 services57 patients

Kidney function blood test panel 80069

A kidney function blood test panel checks how well your kidneys are working. It measures levels of various substances in your blood, including proteins, electrolytes, and waste products. The results can help detect potential kidney issues early.

58 services56 patients

Magnesium level 83735

A magnesium level test is a simple blood test that measures the amount of magnesium in your body. Magnesium is a crucial mineral that helps your nerves, muscles, and heart function properly. The test can help detect health conditions like kidney disease or malnutrition.

58 services56 patients

Creatinine level to test for kidney function or muscle injury 82570

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

41 services40 patients

Total protein level, urine 84156

The Total Protein Level in urine test measures the amount of protein present in your urine. This helps to check kidney health as high levels may indicate a problem. It's a simple, non-invasive procedure involving a urine sample.

41 services40 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Willis Knighton Medical Center

Acute Care Hospitals · Shreveport, LA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number190111

Location2600 Greenwood RoadShreveport, LA 71103 · Caddo County

Emergency services Birthing friendly

Texas Health Harris Methodist Hospital Alliance

Acute Care Hospitals · Fort Worth, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number670085

Location10864 Texas Health TrailFort Worth, TX 76244 · Tarrant County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 71101 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.60 typical visit price

range $53.43 – $164.73

Typical copayment $20.90 (range $13.35 – $41.18)

Most-billed visit code 99203

Established Patient

$95.09 typical visit price

range $16.64 – $133.62

Typical copayment $23.77 (range $4.16 – $33.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

80.02/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

69.03

Promoting Interoperability

100

Improvement Activities

Cost

40.12

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SRINIVASA R ISKAPALLI MD

Internal Medicine (Nephrology)