NPIMap

Individual provider Active NPI

Kelly Lanier Paulk, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Kenner, LA
National Provider Identifier
1083034557
Registry record updated Aug 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
308434 Issued in LA
Practice address
200 W Esplanade Ave
Kenner, LA 70065-2489
Phone
(504) 443-9500
NPI assigned
Apr 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 308434 LA
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 308434 LA Primary

Addresses

Primary practice location

200 W Esplanade Ave
Kenner, LA 70065-2489

Mailing address

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-4000

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
I20190824000609 LA Practitioner - Interventional Pain ManagementPractitioner - Physical Medicine and Rehabilitation 9830496678 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
Louisiana State University School of Medicine in New Orleans, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

200 W Esplanade Ave
Ochsner Clinic Kenner Mob
Kenner, LA 70065-2489
Phone (504) 842-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Jul 29, 2019 Accepting new patients
Ochsner Bayou LLC Interventional Pain Medicine Current Accepting new patients
Ochsner Clinic LLC CurrentSince Jul 29, 2019 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Ochsner Pharmacy and Wellness, LLC Past Accepting new patients

Locations

200 W Esplanade Ave
Kenner, LA 70065
Phone (504) 464-2940

200 W Esplanade Ave
Ste 702
Kenner, LA 70065
Phone (504) 467-0770

4150 Nelson Rd
Ste G
Lake Charles, LA 70605
Phone (337) 310-0440

1514 Jefferson Hwy
New Orleans, LA 70121

141 Twin Oaks Dr
Raceland, LA 70394
Phone (985) 447-3889

Interoperability endpoints

  • Direct secure messaging: kpaulk227200@direct.ochsner.org

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 and National Provider Directory roles.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1083034557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ESPLANADE AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652489",
            "telephone_number": "504-443-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULK",
        "first_name": "KELLY",
        "middle_name": "LANIER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-23",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "LA",
            "license": "308434",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "LA",
            "license": "308434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenner, LA

Sources for this page

Verify at the official NPI Registry.