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SOUTH SHREVEPORT INTERNAL MEDICINE
NPI 1982635249
Internal Medicine in Shreveport, LA

Active since July 05, 2006CLIA 19D0699958 · Waiver
2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 301, SHREVEPORT, LA 71118(318) 212-5991(318) 212-5018 Get Directions Write a Review

NPPES record last updated: August 30, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About South Shreveport Internal Medicine NPPES

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

SOUTH SHREVEPORT INTERNAL MEDICINE (NPI 1982635249) is a healthcare organization registered as an internal medicine in Shreveport, Louisiana and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through March 23, 2027 and lists Greg J. Gavin, Network Administrator, as its authorized official.

NPPES Registry Identity

NPI1982635249
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameSOUTH SHREVEPORT INTERNAL MEDICINE
Location Address2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 301Shreveport, LA 71118-3133
Mailing Address2508 Bert Kouns Industrial Loop, Suite 301Shreveport, LA 71118-3133 · (318) 212-5991 · Fax (318) 212-5018
Phone(318) 212-5991
Fax(318) 212-5018
Organization SubpartNo
Authorized OfficialGreg J. GavinNetwork Administrator · (318) 212-4232
Enumeration DateJuly 5, 2006
Last NPPES UpdateAugust 30, 2022
NPPES CertifiedAugust 30, 2022
✔ NPI 1982635249 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2508 BERT KOUNS INDUSTRIAL LOOP, Shreveport, LA 71118
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Other Identifiers 1

Medicaid1448885LA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 19D0699958

South Shreveport Internal Medicine · Shreveport, LA
Active · expires Mar 23, 2027
CLIA Number19D0699958
Laboratory TypePhysician Office
Certificate Effective DateMarch 24, 2025
Certificate Expiration DateMarch 23, 2027
Laboratory DirectorRoopashree Muralidhar
Laboratory Phone(318) 212-5991
Laboratory LocationSouth Shreveport Internal Medicine2508 Bert Kouns #301, Shreveport, LA 71118
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

CATHERINE F. VANDERLOOS, MD FACOG AMC
Specialist
2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 400
SHREVEPORT, LA 71118
Caddo Parish (318) 687-1992
WK SOUTH OB-GYN CLINIC
Obstetrics & Gynecology
2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 305
SHREVEPORT, LA 71118
Caddo Parish (318) 688-5316
WK PSYCHOLOGY SPECIALTY CENTER
Psychologist (Clinical)
2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 303
SHREVEPORT, LA 71118
Caddo Parish (318) 212-5850
DR. JAMES R. ALEXANDER JR. M.D.
Obstetrics & Gynecology
2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 105
SHREVEPORT, LA 71118
Caddo Parish (318) 688-1204
WK SOUTH SHREVEPORT WOMENS HEALTH CLINIC
Obstetrics & Gynecology
2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 207
SHREVEPORT, LA 71118
Caddo Parish (318) 212-5343
SUSAN M SEILER-SMITH & WILLIS-KNIGHTON MEDICAL CENTER
Internal Medicine
2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 301
SHREVEPORT, LA 71118
Caddo Parish (318) 686-8808
ANNA M. CRAIG MD
Pediatrics
2508 BERT KOUNS INDUSTRIAL LOOP, STE 320
SHREVEPORT, LA 71118
Caddo Parish (318) 212-5990
FREDERICK JOHN KINDER JR. MD
Obstetrics & Gynecology
2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 201
SHREVEPORT, LA 71118
Caddo Parish (318) 688-8804

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 South Shreveport Internal Medicine's NPI number?

The NPI number for South Shreveport Internal Medicine is 1982635249. It was assigned to this organization in the NPPES registry on July 5, 2006.

Where is South Shreveport Internal Medicine located?

South Shreveport Internal Medicine is located at 2508 Bert Kouns Industrial Loop Suite 301, Shreveport, LA 71118. The listed phone number is (318) 212-5991.

What is South Shreveport Internal Medicine's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does South Shreveport Internal Medicine hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 19D0699958) is associated with this NPI, valid through March 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for South Shreveport Internal Medicine was last updated on August 30, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.