Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

John M Provenza, MD

Individual provider Gastroenterology Physician · NPI 1225028434

John M Provenza, MD is a Gastroenterology in Shreveport, Louisiana. Graduated from Louisiana State University School of Medicine in Shreveport in 1984, 42 years ago. Practices with Gi Specialists Hospitalists at Wkmc, a 12-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
42
Trained at
Louisiana State University School of Medicine in Shreveport
Licensed in
LA
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

8383 Millicent Way Ste B
Shreveport, LA 71115
Phone: (318) 631-9121
Fax: (318) 213-6246
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gastroenterology Physician (primary) Taxonomy 207RG0100X · Licence 017860 (LA)

Record details

NPI number1225028434
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 27, 2005
Last updated in NPPESAugust 12, 2022
Certification dateAugust 12, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGASTROENTEROLOGY
Medical schoolLOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated 1984 (42 years in practice)
Group practice Gi Specialists Hospitalists At Wkmc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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