OrganizationActive
All Age Medical P.C., Inc.
NPI 1548440811 · Medical Specialty Clinic/Center · Bossier City, LA
Provider details
- NPI number
- 1548440811
- Entity type
- Organization
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Andrea Blake-Mcmahon, Ceo(318) 741-8100
- License
- 14851R (LA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
2910 Shed Rd
Suite B
Bossier City, LA 71111-3154
Phone: (318) 741-8100
Fax: (318) 741-5700
Street-level locationGet directions
Mailing address
2910 Shed Rd
Bossier City, LA 71111-3154
Registry dates
- Enumerated
- 2007-11-05
- Last updated
- 2012-01-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.