NPIMap

Individual provider Active NPI

Latonya Renae Kelly, M.D.

  • Family Medicine Physician
  • Opelousas, LA
National Provider Identifier
1063430213
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
200059 Issued in LA
Practice address
3921 I 49 S Service Rd
Opelousas, LA 70570-0758
Phone
(337) 942-5706
Fax
(337) 942-2644
NPI assigned
Jul 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 200059 LA Primary

Addresses

Primary practice location

3921 I 49 S Service Rd
Opelousas, LA 70570-0758

Mailing address

3921 I 49 S Service Rd
Opelousas, LA 70570-0758
Phone (337) 942-5706

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
I20060928000133 LA Practitioner - Family PracticePractitioner - General Practice 4688679590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7373 Perkins Rd
Baton Rouge, LA 70808-4326
Phone (225) 246-9790

7373 Perkins Rd
Baton Rouge, LA 70808-4373

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200059LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baton Rouge Clinic, a Medical Corporation CurrentSince Nov 13, 2023 Accepting new patients
Baton Rouge Clinic, a Medical Corporation CurrentSince Nov 13, 2023 Accepting new patients
Opelousas Healthcare Properties LLC Past Accepting new patients
Fairway Medical Urgent Care LLC Past Accepting new patients

Locations

7373 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 246-9790

3921 I 49 S Service Rd
Opelousas, LA 70570
Phone (337) 942-5706

Interoperability endpoints

  • Direct secure messaging: lkelly5249969@direct.casso.us.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Heritage Manor of OpelousasOpelousas, LA, CCN 195321 Skilled nursing facility Adp of the SNF Nov 21, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 7

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

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063430213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3921 I 49 S SERVICE RD",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705700758",
            "telephone_number": "337-942-5706",
            "fax_number": "337-942-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 I 49 S SERVICE RD",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705700758",
            "telephone_number": "337-942-5706",
            "fax_number": "337-942-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LATONYA",
        "middle_name": "RENAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "200059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Opelousas, LA

Sources for this page

Verify at the official NPI Registry.