Mr Mark Alan Cogburn, LPC,LMFT is a medicare enrolled "Clinical Nurse Specialist" provider in Shreveport, Louisiana. His current practice location is
1541 Kings Hwy, Shreveport, Louisiana. You can reach out to his office (for appointments etc.) via phone at
(318) 626-0000.
Mr Mark Alan Cogburn is licensed to practice in Louisiana (license number AP06313) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1952458713.
Healthcare Provider's Profile
Full Name | Mr Mark Alan Cogburn |
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Gender | Male |
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Speciality | Clinical Nurse Specialist |
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Location | 1541 Kings Hwy, Shreveport, Louisiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1952458713
- Provider Enumeration Date: 01/04/2007
- Last Update Date: 09/17/2024
Medicare PECOS Information:
- PECOS PAC ID: 6507026358
- Enrollment ID: I20120402000310
Medical Identifiers
Medical identifiers for Mr Mark Alan Cogburn such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1952458713 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YP2500X | Counselor - Professional | 1595 (Louisiana) | Secondary |
106H00000X | Marriage & Family Therapist | 177 (Louisiana) | Secondary |
364S00000X | Clinical Nurse Specialist | AP06313 (Louisiana) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Mark Alan Cogburn allows following entities to bill medicare on his behalf.
Entity Name | Louisiana State University Health Sciences Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1417992249 PECOS PAC ID: 6103730908 Enrollment ID: O20031208000275 |
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Entity Name | Lsu Health Sciences Center Shreveport Faculty Group Practice |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1013374222 PECOS PAC ID: 4082902721 Enrollment ID: O20161012000307 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Mark Alan Cogburn is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Mark Alan Cogburn, LPC,LMFT 1541 Kings Hwy, Attn: Payor Credentialing, Shreveport, LA 71103-4228 Ph: (318) 626-0287 | Mr Mark Alan Cogburn, LPC,LMFT 1541 Kings Hwy, Shreveport, LA 71103 Ph: (318) 626-0000 |
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