Individual provider Active NPI

Kaylie Devall, FNP

  • Registered Nurse
  • Denham Springs, LA
National Provider Identifier
1093576753
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN156427 Issued in LA
Practice address
10130 Crossing Way Ste 335
Denham Springs, LA 70726-5889
Phone
(225) 667-2777
NPI assigned
Jan 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 234477 LA
Registered Nurse 163W00000X RN156427 LA Primary

Addresses

Primary practice location

10130 Crossing Way Ste 335
Denham Springs, LA 70726-5889

Mailing address

10130 Crossing Way Ste 335
Denham Springs, LA 70726-5889
Phone (225) 667-2777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN156427LAMDRegistered Nurse
234477LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pedicons, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EAECAD/Endpoint/EAECAD

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1093576753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10130 CROSSING WAY STE 335",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707265889",
            "telephone_number": "225-667-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10130 CROSSING WAY STE 335",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707265889",
            "telephone_number": "225-667-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVALL",
        "first_name": "KAYLIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "234477",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN156427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denham Springs, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.