Individual provider Active NPI

Kristy Keller Parent, PA

  • Surgical Physician Assistant
  • Baton Rouge, LA
National Provider Identifier
1104081033
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
200187 Issued in LA
Practice address
8300 Constantin Blvd
Baton Rouge, LA 70809-3489
Phone
(225) 374-1410
Fax
(225) 374-1616
NPI assigned
Jul 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 200187 LA Primary

Addresses

Primary practice location

8300 Constantin Blvd
Baton Rouge, LA 70809-3489

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 526-0011

Other identifiers 2

IdentifierTypeStateIssuer
1170526MedicaidLA
07801816MedicaidMS

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kparent15929@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090810000046 LA Practitioner - Physician Assistant 1355415225 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200187LAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Feb 1, 2015 Accepting new patients
Our Lady of the Lake Hospital Inc Past Accepting new patients

Locations

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

8200 Constantin Blvd
Ste 200
Baton Rouge, LA 70809
Phone (225) 709-8633

8200 Constantin Blvd
Fl 4
Baton Rouge, LA 70809

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

5439 Airline Hwy
Baton Rouge, LA 70805
Phone (225) 358-2280

8300 Constantin Blvd
Baton Rouge, LA 70809
Phone (225) 374-1410

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.

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1104081033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-526-0011",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 CONSTANTIN BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093489",
            "telephone_number": "225-374-1410",
            "fax_number": "225-374-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARENT",
        "first_name": "KRISTY",
        "middle_name": "KELLER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "LA",
            "license": "200187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1170526",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07801816",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kparent15929@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kparent15929@direct.casso.us.com",
            "address_1": "8300 Constantin Blvd",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708093489",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "8300 Constantin Blvd",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708093489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.