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

Mr. Justin Moore, PHYSICIANASSISTANT

Individual provider Medical Physician Assistant · NPI 1831743699

Mr. Justin Moore, PHYSICIANASSISTANT is a Physician Assistant in Shreveport, Louisiana. Qualified in 2025, 1 year ago. Practices with LSU Health Sciences Center Shreveport Faculty Group Practice, a 569-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
1
Licensed in
LA
In the registry since
2019
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Practice location Address checks out

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone: (870) 510-0171
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 346971 (LA)

Record details

NPI number1831743699
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedJuly 30, 2019
Last updated in NPPESMay 23, 2025
Certification dateMay 23, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Lsu Health Sciences Center Shreveport Faculty Group Practice — 569 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Shreveport