| NPI | 1023012960 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2005-06-09 |
| Last Updated | 2020-12-11 |
| Mailing Address | 1455 E Bert Kouns Loop Shreveport, LA 71105-5634 United States Phone: (318) 798-4488 | Fax: (318) 798-4672 📍 View Map |
| Primary Practice Address | 1455 E Bert Kouns Loop Shreveport, LA 71105-5634 United States Phone: (318) 798-4577 | Fax: (318) 798-4672 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | LA | 1053315846 | Group NPI Number |
| Other (non-Medicare) | LA | 110091280 | Railroad Medicare Number |
| MEDICAID | LA | 1358070 | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 207R00000X – Internal Medicine | LA | 017132 |
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About NPI 1023012960
Roan L Flenniken MD is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1023012960. The primary specialty listed is Internal Medicine. The provider is located in Shreveport, LA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2005-06-09. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1023012960?
NPI 1023012960 belongs to Roan L Flenniken MD, a Internal Medicine in Shreveport, LA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1023012960 active?
The current status of NPI 1023012960 in the NPPES registry is Active. The record was last updated on 2020-12-11.
What specialty is NPI 1023012960?
NPI 1023012960 is classified under the taxonomy Internal Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1023012960?
You can verify NPI 1023012960 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1023012960?
The primary practice address on file for NPI 1023012960 is 1455 E Bert Kouns Loop, Shreveport, LA 71105-5634. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1023012960 issued?
NPI 1023012960 was first issued (enumerated) on 2005-06-09. The NPPES record was last updated on 2020-12-11.
Practice Location Map
Roan L Flenniken is located at 1455 E Bert Kouns Loop, Shreveport, LA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Roan L Flenniken. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1023012960. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Internal Medicine | 017132 | LA |