Southside Foot Clinic of Shreveport, Inc. a Professional Corporation
NPI 1033111240 · Foot & Ankle Surgery Podiatrist · Shreveport, LA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southside Foot Clinic of Shreveport, Inc. a Professional Corporation is a Foot & Ankle Surgery Podiatrist organization in Shreveport, LA (NPI 1033111240).
Provider details
- NPI number
- 1033111240
- Entity type
- Organization
- Primary specialty
- Foot & Ankle Surgery PodiatristPodiatric Medicine & Surgery Service Providers
- Organization subpart
- No
- Authorized official
- Richard Havens, Physician/Administrator(318) 687-6266
- License
- 5B496 (LA)
Specialties & taxonomies
Podiatric Medicine & Surgery Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
21 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Southside Foot Clinic
Registry dates
- Enumerated
- 2005-06-01
- Last updated
- 2025-12-29
- Certified
- 2025-12-29
Frequently asked questions
- What is Southside Foot Clinic of Shreveport, Inc. a Professional Corporation's NPI number?
- Southside Foot Clinic of Shreveport, Inc. a Professional Corporation's National Provider Identifier (NPI) is 1033111240, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southside Foot Clinic of Shreveport, Inc. a Professional Corporation?
- Southside Foot Clinic of Shreveport, Inc. a Professional Corporation is classified in the NPPES registry as Foot & Ankle Surgery Podiatrist (Podiatric Medicine & Surgery Service Providers).
- Where is Southside Foot Clinic of Shreveport, Inc. a Professional Corporation located?
- Southside Foot Clinic of Shreveport, Inc. a Professional Corporation's practice location on file with NPPES is 9308 Mansfield Rd, Shreveport, LA 71118-3134.
- What is Southside Foot Clinic of Shreveport, Inc. a Professional Corporation's phone number?
- The practice phone number listed in the NPPES registry for Southside Foot Clinic of Shreveport, Inc. a Professional Corporation is (318) 687-6266.
- Does Southside Foot Clinic of Shreveport, Inc. a Professional Corporation accept Medicare?
- Southside Foot Clinic of Shreveport, Inc. a Professional Corporation is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Southside Foot Clinic of Shreveport, Inc. a Professional Corporation?
- The authorized official listed on Southside Foot Clinic of Shreveport, Inc. a Professional Corporation's NPPES record is Richard Havens, Physician/Administrator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southside Foot Clinic of Shreveport, Inc. a Professional Corporation's NPI active?
- Yes — Southside Foot Clinic of Shreveport, Inc. a Professional Corporation's NPI (1033111240) is active in the NPPES registry as of the last update on 2025-12-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.