Kenner Emergency Group LLC
Organization Active NPI Emergency Medicine Physician · Kenner, LA
NPI 1013986546 · NPPES record last updated Mar 23, 2022
Key facts
- NPI
- 1013986546
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- KENNER EMERGENCY GROUP LLC
- Practice address
- 180 W Esplanade Ave
Kenner, LA 70065-2467 - Phone
- (504) 468-8600
- NPI assigned
- Mar 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Lisha C Falk
- Title
- VP of Contracting
- Phone
- (337) 609-1221
Practitioners 231
-
Brent Lewis Allen, M.D.
-
Everett Wade Brown, M.D.
-
Jon M. Cuba, M.D.
-
Adam Fleming, FNP-C
-
John M. Langley, M.D.
-
Blake Randall Lavespere, PHYSICIAN ASSISTANT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041111000475 | LA | Part B Supplier - Clinic/Group Practice | 8426011230 |
Receives reassigned benefits from 231 practitioners Practice locations: Kenner, LA; Marrero, LA |
National Provider Directory
Locations
4837 Lapalco Blvd
Marrero, LA 70072
Phone (504) 703-3250
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes | ||
| Medical Physician Assistant |
363AM0700X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
180 W Esplanade Ave
Kenner, LA 70065-2467
Mailing address
200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698
Other practice location 1
4837 Lapalco Blvd
Marrero, LA 70072-4325
Phone (504) 703-3260
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06305002 | Medicaid | MS | |
| 1447072 | Medicaid | LA |
Other providers in Kenner, LA
- Christal Keller
- Kelly Optometry, a Professional Corporation
- Dakeitha Kelly
- Kenner Dental Associates, LLC
- Kenner Dental Company LLC
- Kenner Outpatient Surgery Center
- Kenner Physician Associates, LLC
- James E Kerl
- KG Express Transportation, LLC
- Kamran Khan
All providers in Kenner, LA · Emergency Medicine Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.