Amanda Lynn Callegan-poche'
Amanda Lynn Callegan · Pediatrics

Address: 1023 Provenance Pl Ste 130, Shreveport, LA 71106-7796
Phone: 3186260000

Amanda Lynn Callegan-poche' (NPI# 1265829394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1265829394
Entity Type Individual
Full Name Amanda Lynn Callegan-poche'
Other Name Amanda Lynn Callegan
Credential MD
Gender Female
Practice Address 1023 Provenance Pl Ste 130
Shreveport
LA 71106-7796
Practice Telephone 3186260000
Mailing Address 1501 Kings Hwy
Med/peds
Shreveport
LA 71103-4228
Mailing Telephone 3188132528
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2015-04-15
Last Update Date 2019-09-04

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
No 207R00000X Internal Medicine Allopathic & Osteopathic Physicians 312618 LA
Yes 208000000X Pediatrics Allopathic & Osteopathic Physicians 312618 LA

Other Provider Identifier

State Identifier Issuer Type Code
LA 2388312 MEDICAID

Secondary Practice Locations

Address Telephone Number Fax Number
1501 Kings Hwy, Med/peds, Shreveport, LA 711034228 3188132528

Physician Overview

NPI 1265829394
PAC ID by PECOS 1052614922
Professional Enrollment ID I20190730000145
Full Name Amanda Callegan-poche'
Organization Legal Name LSU HEALTH SCIENCES CENTER-SHREVEPORT FACULTY GROUP PRACTICE
Phone Number 3186756402
Gender F
Medical School LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduation Year 2015
Primary Specialty INTERNAL MEDICINE
Secondary Specialties PEDIATRIC MEDICINE
Group Practice PAC ID 4082902721
Number of Group Practice Members 381
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
190098 UNIVERSITY HEALTH SHREVEPORT

Taxonomy Information

Taxonomy Code 208000000X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics

Taxonomy Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio
- Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1487066296 Alfred W. Hathorn Jr., M.d. Apmc Pediatrics 2120 Bert Koun Loop, Suite # L, Shreveport, LA 71118-3351 2014-05-28
1619311438 Amanda Vice Haynie Pediatrics 2225 Line Avenue, Mid City Pediatrics, Shreveport, LA 71104 2013-04-23
1487913976 Greg M Oji Pediatrics 2508 Bert Kouns Industrial Loop Ste 320, Shreveport, LA 71118-3154 2012-05-03
1497011001 Tamara Lynn Moore Pediatrics 1811 E Bert Kouns Industrial Loop Ste 140, Shreveport, LA 71105-5741 2012-04-09
1316228984 Choice Pediatrics, LLC Pediatrics 6930 Fern Ave, Suite 150, Shreveport, LA 71105-4100 2011-09-08
1598077323 Virginia Homza Carter Pediatrics 909 Olive St, Shreveport, LA 71104 2010-07-09
1891938239 Nicolette Humphries Pediatrics 2518 Bert Kouns Ind. Loop, Shreveport, LA 71118-3112 2009-04-15
1407042435 Hester Suh Pediatrics 2709 Mackey Ln, Shreveport, LA 71118-2556 2007-09-24
1639203367 Suyah M Loud Pediatrics 4140 Hollywood Ave, Suite B-2, Shreveport, LA 71109-7818 2007-03-15
1891833869 Holliway Medical Clinic LLC Pediatrics 3824 Hearne Ave, Shreveport, LA 71103 2007-02-02
Find all providers in SHREVEPORT

Office Location

Street Address 1023 PROVENANCE PL STE 130
City SHREVEPORT
State LA
Zip Code 71106-7796

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1972008332 Andrew Joseph Brouillette Dentist 385 Bert Kouns Industrial Loop Ste 700, Shreveport, LA 71106 2018-03-28
1548775885 David Wayne Spears Pharmacist 10460 Norris Ferry Road, Shreveport, LA 71106 2017-12-08
1225559263 Susan Anderson Roblow Physical Therapist 921 Unadilla Street, Shreveport, LA 71106 2017-06-29
1134656382 James Lowder Dentist 8691 Line Ave Ste 300, Shreveport, LA 71106 2017-05-18
1144753708 Laverne Brantley Counselor 328 E 69th St, Shreveport, LA 71106 2017-04-10
1437690849 Biostat Laboratories, LLC Clinical Medical Laboratory 9742 Saint Vincent Ave Ste 200, Shreveport, LA 71106 2017-03-17
1841730728 Cedric Thomas Case Manager/Care Coordinator 6811 Fairfield Avenue, Shreveport, LA 71106 2017-02-27
1225576192 Nick Vergis Pharmacist 5828 Line Avenue, Shreveport, LA 71106 2017-02-10
1184162554 Marilyn Johnson Case Manager/Care Coordinator 9245 Wallace Lake Rd Ste A, Shreveport, LA 71106 2017-02-06
1417499740 Pamela Lee Counselor 8802 Coyth Ln, Shreveport, LA 71106 2016-11-17
Find all providers in zip 71106

Competitor

Search similar providers

City SHREVEPORT
Zip Code 71106

Improve Information

Please comment or provide details below to improve the information on Amanda Lynn Callegan-poche'.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.