NPIMap

Individual provider Active NPI

Kelly G White, PA-C

  • Medical Physician Assistant
  • Alexandria, LA
National Provider Identifier
1063415180
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
A10535 Issued in LA
Practice address
605B Medical Center Dr
Alexandria, LA 71301-8127
Phone
(318) 442-2232
Fax
(318) 442-2192
NPI assigned
May 23, 2005
Last updated
Aug 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X A10535 LA Primary
Hematology & Oncology Physician 207RH0003X PA.A10535 LA

Addresses

Primary practice location

605B Medical Center Dr
Alexandria, LA 71301-8127

Mailing address

PO Box 8255
Alexandria, LA 71306-1255
Phone (318) 442-2232

Other practice location 1

2108 Texas Ave
Alexandria, LA 71301-3944
Phone (318) 442-2232

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100726000415 LA Practitioner - Physician Assistant 2567594641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800
Phone (318) 681-4138

2108 Texas Ave
Alexandria, LA 71301-3903

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
A10535LAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rapides Healthcare System, LLC CurrentSince Jun 1, 2019 Accepting new patients
Rapides Healthcare System LLC CurrentSince Jun 1, 2019 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 4, 2022 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 4, 2022 Accepting new patients

Locations

2108 Texas Ave
Ste 3061
Alexandria, LA 71301
Phone (318) 442-2232

211 4th St
Alexandria, LA 71301
Phone (318) 473-3000

3330 Masonic Dr
Alexandria, LA 71301
Phone (318) 448-6917

605 Medical Center Dr
Ste B
Alexandria, LA 71301
Phone (225) 767-0822

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

Interoperability endpoints

  • Direct secure messaging: kwhite433223@christushealth.direct-ci.net

Organizations & group practices 5

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.

Hospital & facility affiliations 22

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1063415180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8255",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713061255",
            "telephone_number": "318-442-2232",
            "fax_number": "318-442-2192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605B MEDICAL CENTER DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713018127",
            "telephone_number": "318-442-2232",
            "fax_number": "318-442-2192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2108 Texas Ave",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "LA",
            "postal_code": "713013944",
            "country_code": "US",
            "telephone_number": "318-442-2232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KELLY",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "A10535",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "LA",
            "license": "PA.A10535",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.