Individual provider Active NPI

Kathryn Wiggins Melancon, MD

  • Pediatrics Physician
  • Destrehan, LA
National Provider Identifier
1104567106
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
346951 Issued in LA
Practice address
13100 River Rd Ste 250
Destrehan, LA 70047-5226
Phone
(985) 764-6036
Fax
(985) 764-0179
NPI assigned
Apr 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 346951 LA Primary
Pediatrics Physician 208000000X 39 LA

Addresses

Primary practice location

13100 River Rd Ste 250
Destrehan, LA 70047-5226

Mailing address

1514 Jefferson Hwy
New Orleans, LA 70121-2429

Other practice location 1

200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone (504) 899-9511

Other names 1

  • Kathryn Wiggins Former name

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
I20260112000524 LA Practitioner - Pediatric Medicine 9638655475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1514 Jefferson Hwy
New Orleans, LA 70121

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
346951LAMDPediatrics Physician
39LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Dec 6, 2025 Accepting new patients
Ochsner Clinic LLC CurrentSince Dec 6, 2025 Accepting new patients
Ochsner Clinic LLC Past Accepting new patients

Locations

13100 River Rd
Ste 250
Destrehan, LA 70047
Phone (985) 764-6036

13100 River Rd
Destrehan, LA 70047
Phone (504) 701-3652

1057 Paul Maillard Rd
Luling, LA 70070
Phone (985) 785-3655

4901 Veterans Memorial Blvd
Metairie, LA 70006
Phone (504) 887-1133

1514 Jefferson Hwy
New Orleans, LA 70121

Interoperability endpoints

  • Direct secure messaging: kellis2467256@direct.ochsner.org

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1104567106",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13100 RIVER RD STE 250",
            "city": "DESTREHAN",
            "state": "LA",
            "postal_code": "700475226",
            "telephone_number": "985-764-6036",
            "fax_number": "985-764-0179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Henry Clay Ave",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701185720",
            "country_code": "US",
            "telephone_number": "504-899-9511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELANCON",
        "first_name": "KATHRYN",
        "middle_name": "WIGGINS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "346951",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "39",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "WIGGINS",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Destrehan, LA

Sources for this page

Verify at the official NPI Registry.