Individual provider Active NPI

Kenneth Boyd Sumner, M.D.

  • Psychiatry Physician
  • Metairie, LA
National Provider Identifier
1073653275
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
020090 Issued in LA
Practice address
3901 Houma Blvd Ste 401
Metairie, LA 70006-2930
Phone
(504) 889-1448
Fax
(504) 885-8752
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 020090 LA Primary

Addresses

Primary practice location

3901 Houma Blvd Ste 401
Metairie, LA 70006-2930

Mailing address

3901 Houma Blvd Ste 401
Metairie, LA 70006-2930
Phone (504) 889-1448

Other identifiers 1

IdentifierTypeStateIssuer
1934194MedicaidLA

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
I20121024000341 LA Practitioner - Psychiatry 2163672338 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Tulane University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson Psychiatric Associates LLCGroup PAC ID 9234361213, 7 clinicians

Practice addresses (Care Compare)

3901 Houma Blvd
Suite 401
Metairie, LA 70006-2930
Phone (504) 889-1448

4200 Houma Blvd
Metairie, LA 70006-2970
Phone (504) 454-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Psychiatric Associates Psychiatry CurrentSince Oct 10, 2021 Accepting new patients
Jefferson Psychiatric Associates LLC Psychiatry CurrentSince Dec 1, 2013 Accepting new patients
Greenbrier Hospital, LLC CurrentSince Dec 1, 2020 Accepting new patients

Locations

201 Greenbrier Blvd
Covington, LA 70433
Phone (866) 652-3940

3340 Severn Ave
Ste 206
Metairie, LA 70002
Phone (504) 889-1448

3901 Houma Blvd
Ste 401
Metairie, LA 70006
Phone (504) 889-1448

Networks

  • LA PPO C-SNP

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/05a97b88-f719-405f-abbb-125ac71b7cee/

Organizations & group practices 3

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

Hospital & facility affiliations 4

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1073653275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 HOUMA BLVD STE 401",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062930",
            "telephone_number": "504-889-1448",
            "fax_number": "504-885-8752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 HOUMA BLVD STE 401",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062930",
            "telephone_number": "504-889-1448",
            "fax_number": "504-885-8752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMNER",
        "first_name": "KENNETH",
        "middle_name": "BOYD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "020090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1934194",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.