Individual provider Active NPI

Kelly Landry Angelle, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Lafayette, LA
National Provider Identifier
1033678271
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
341021 Issued in LA
Practice address
4704 Ambassador Caffery Pkwy FL 2
Lafayette, LA 70508-6908
Phone
(337) 470-5920
Fax
(855) 431-6867
NPI assigned
Mar 18, 2019
Last updated
Aug 31, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 341021 LA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4704 Ambassador Caffery Pkwy FL 2
Lafayette, LA 70508-6908

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (337) 470-5920

Other practice location 1

200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone (504) 896-9458

Other practice location 2

2021 Perdido St Fl 6
New Orleans, LA 70112-1352
Phone (504) 568-4082

Other names 1

  • Kelly Elizabeth Landry Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240930000405 LA Practitioner - NeurologyPractitioner - Pediatric Medicine 3274064498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Pediatric Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone (504) 412-1860

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
341021LAMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana State University School of Med in New Orleans Faculty Grou CurrentSince Sep 1, 2024 Accepting new patients
Lsuhsc New Orleans Physicians Past Accepting new patients

Locations

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1033678271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "337-470-5920",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4704 AMBASSADOR CAFFERY PKWY FL 2",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086908",
            "telephone_number": "337-470-5920",
            "fax_number": "855-431-6867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Henry Clay Ave",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701185720",
            "country_code": "US",
            "telephone_number": "504-896-9458",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2021 Perdido St Fl 6",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701121352",
            "country_code": "US",
            "telephone_number": "504-568-4082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANGELLE",
        "first_name": "KELLY",
        "middle_name": "LANDRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "LA",
            "license": "341021",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "LANDRY",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.