NPIMap

Organization Active NPI

KCC, Inc

  • Home Infusion Agency
  • Shreveport, LA
National Provider Identifier
1043520968
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion AgencyTaxonomy code 251F00000X
Legal business name
KCC, INC
Doing business as
Vital Care Rx
Practice address
8625 Line Ave Ste a
Shreveport, LA 71106-6107
Phone
(318) 673-8360
Fax
(318) 673-8940
NPI assigned
Oct 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Authorized official

Name
Brad Gilchrist
Title
Coo
Phone
(601) 482-4003

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Agency 251F00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X 006322-IR LA
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 006322-IR LA
Pharmacy 333600000X 6322 LA
Home Infusion Therapy Pharmacy 3336H0001X 006322-IR LA

Addresses

Primary practice location

8625 Line Ave Ste a
Shreveport, LA 71106-6107

Mailing address

1501 23Rd Ave
Meridian, MS 39301-4027
Phone (318) 673-8360

Other identifiers 1

IdentifierTypeStateIssuer
2200429MedicaidLA

Other names 1

  • Vital Care Rx Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130429000551 LA DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 1759382047 Practice locations: Shreveport, LA
O20130913000167 LA Part B Supplier - Pharmacy 1759382047 Practice locations: Shreveport, LA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
KCC Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785196800000",
    "number": "1043520968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 23RD AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014027",
            "telephone_number": "318-673-8360",
            "fax_number": "888-970-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8625 LINE AVE STE A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711066107",
            "telephone_number": "318-673-8360",
            "fax_number": "318-673-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KCC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-13",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A",
        "authorized_official_last_name": "GILCHRIST",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "601-482-4003"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "LA",
            "license": "006322-IR",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "LA",
            "license": "006322-IR",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "LA",
            "license": "6322",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "LA",
            "license": "006322-IR",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2200429",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vital Care Rx",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vital Care Rx",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.