Individual provider Active NPI

Kevin Mark Ricks, PA

  • Medical Physician Assistant
  • Houma, LA
National Provider Identifier
1104867258
Registry record updated Jun 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
A10312RX Issued in LA
Practice address
1990 Industrial Boulevard
Houma, LA 70363-7055
Phone
(985) 868-9300
Fax
(985) 851-0053
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X A10312RX LA Primary

Addresses

Primary practice location

1990 Industrial Boulevard
Houma, LA 70363-7055

Mailing address

1990 Industrial Boulevard
Houma, LA 70363-7055
Phone (985) 868-9300

Other identifiers 1

IdentifierTypeStateIssuer
1626759MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, AL, TX3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20090211000292 LA Practitioner - Physician Assistant 8123183928 Reassigns benefits to 2 organizations
I20151023001385 AL Practitioner - Physician Assistant 8123183928 Reassigns benefits to 1 organization
I20191125002632 TX Practitioner - Physician Assistant 8123183928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

104 Acadia Park Dr
Raceland, LA 70394-2618
Phone (985) 537-3211

12895 Hwy 90
Suite H
Luling, LA 70070-2249
Phone (985) 331-9400

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3000

1516 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3470

3417 Williams Blvd
Kenner, LA 70065-3725
Phone (504) 461-9660

4100 Canal St
New Orleans, LA 70119-5941
Phone (504) 831-3112

Hospital & facility affiliations

  • Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A10312RXLAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Singleton Associates PA Physician Assistant CurrentSince Oct 22, 2019 Accepting new patients
Ochsner Clinic LLC CurrentSince Oct 29, 2020 Accepting new patients
Ochsner Clinic LLC Past Accepting new patients
Ochsner Clinic LLC Past Accepting new patients
Ochsner Clinic LLC Past Accepting new patients

Locations

1111 Greengate Dr
Ste B
Covington, LA 70433
Phone (985) 246-2420

5922 W Main St
Ste A
Houma, LA 70360
Phone (985) 262-8015

3417 Williams Blvd
Kenner, LA 70065
Phone (504) 461-9660

12895 Highway 90
Ste H
Luling, LA 70070
Phone (985) 331-9400

2215 Veterans Memorial Blvd
Metairie, LA 70002
Phone (504) 838-3524

4100 Canal St
New Orleans, LA 70119
Phone (504) 703-2750

4605 Magazine St
New Orleans, LA 70115
Phone (504) 883-8111

900 Magazine St
New Orleans, LA 70130
Phone (504) 309-0534

1514 Jefferson Hwy
New Orleans, LA 70121

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

9605 Jefferson Hwy
Ste G
River Ridge, LA 70123
Phone (337) 853-0999

318 N Canal Blvd
Thibodaux, LA 70301
Phone (985) 446-3276

Organizations & group practices 8

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 1

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244419200000",
    "number": "1104867258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 INDUSTRIAL BOULEVARD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703637055",
            "telephone_number": "985-868-9300",
            "fax_number": "985-851-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 INDUSTRIAL BOULEVARD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703637055",
            "telephone_number": "985-868-9300",
            "fax_number": "985-851-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKS",
        "first_name": "KEVIN",
        "middle_name": "MARK",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2009-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "A10312RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1626759",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

Verify at the official NPI Registry.