| Emd Telehealth Solutions Llc | |
|
1000 Chinaberry Dr Ste 800, 500 Bossier City LA 71111-2455 | |
| (318) 392-3372 | |
| (318) 392-3373 |
| Full Name | Emd Telehealth Solutions Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1000 Chinaberry Dr Ste 800, 500, Bossier City, Louisiana |
| Authorized Official Name and Position | Joseph Murray Monsour (CEO) |
| Authorized Official Contact | 3182502587 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emd Telehealth Solutions Llc 3800 Viking Drive Bossier City LA 71111-3526 Ph: (318) 392-3372 | Emd Telehealth Solutions Llc 1000 Chinaberry Dr Ste 800, 500 Bossier City LA 71111-2455 Ph: (318) 392-3372 |
| NPI Number | 1639771124 |
|---|---|
| Provider Enumeration Date | 11/10/2020 |
| Last Update Date | 05/09/2024 |
| Certification Date | 05/09/2024 |
| Medicare PECOS PAC ID | 4082027511 |
|---|---|
| Medicare Enrollment ID | O20201230001438 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639771124 | NPI | - | NPPES |
| Provider Name | Adam S Mossallati |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1447517974 PECOS PAC ID: 0345548574 Enrollment ID: I20160622001074 |
| Provider Name | Tammy Jo Bauldin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437347002 PECOS PAC ID: 0446545859 Enrollment ID: I20160824002465 |
| Provider Name | Kelly Smith Crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588938450 PECOS PAC ID: 3375973548 Enrollment ID: I20200501000591 |
| Provider Name | Cara M Permenter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942741376 PECOS PAC ID: 0446524243 Enrollment ID: I20200707001724 |
| Provider Name | Heather Gros Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033841036 PECOS PAC ID: 3375910052 Enrollment ID: I20221109002291 |
| Provider Name | Elizabeth D Carlisle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982319679 PECOS PAC ID: 1850766528 Enrollment ID: I20230411001634 |
| Provider Name | Amanda Keator Celles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902391170 PECOS PAC ID: 2163877754 Enrollment ID: I20231017003885 |
| Provider Name | Dillon Parker Jones |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1265181838 PECOS PAC ID: 2466980149 Enrollment ID: I20250108002479 |
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