| Dr Chesley Lelwynn Gregory, MD,OD | |
|
9425 Healthplex Dr Ste 101, Shreveport, LA 71106-8154 | |
| (318) 683-5171 | |
| (318) 683-5182 |
| Full Name | Dr Chesley Lelwynn Gregory |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 17 Years |
| Location | 9425 Healthplex Dr Ste 101, Shreveport, Louisiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861410730 | NPI | - | NPPES |
| 1578240 | Medicaid | LA | |
| 1150631 | Medicaid | LA | |
| 1578240 | Other | LA | MEDICAID (TIE BREAKER TAXONOMY 207Q00000X) |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 765-002T (Louisiana) | Secondary |
| 207P00000X | Emergency Medicine | 202699 (Louisiana) | Secondary |
| 207Q00000X | Family Medicine | 202699 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Desoto Regional Health System | Mansfield, LA | Hospital |
| Christus Health Shreveport - Bossier | Shreveport, LA | Hospital |
| Willis Knighton Medical Center, Inc | Shreveport, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Healthplex Family Clinic, Llc | 1850361742 | 3 |
| Oakdale Ess Llc | 7517289713 | 19 |
| Provider Name | Healthplex Family Clinic, Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1053495374 PECOS PAC ID: 1850361742 Enrollment ID: O20040728001032 |
| Provider Name | Oakdale Ess Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1750785119 PECOS PAC ID: 7517289713 Enrollment ID: O20141125000402 |
| Provider Name | Leatherwood Emergency Group Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1760946313 PECOS PAC ID: 0749521250 Enrollment ID: O20190410002335 |
| Provider Name | Hodges Emergency Group Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1710441316 PECOS PAC ID: 2567703978 Enrollment ID: O20190412000898 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Chesley Lelwynn Gregory, MD,OD 9425 Healthplex Dr Ste 101, Shreveport, LA 71106-8154 Ph: (318) 683-5171 | Dr Chesley Lelwynn Gregory, MD,OD 9425 Healthplex Dr Ste 101, Shreveport, LA 71106-8154 Ph: (318) 683-5171 |