Roger Everett Kelley, M.D.

Primary specialty

Vascular Neurology PhysicianTaxonomy code 2084V0102X

License

MD.013686 Issued in LA

Practice address

1541 Kings Hwy
Shreveport, LA 71103-4228

Phone

(318) 626-0000

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Neurology

Education

Tulane University School of Medicine, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lsu Health Sciences Center Shreveport Faculty Group PracticeGroup PAC ID 4082902721, 567 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Lsu Health Shreveport Hospital, Shreveport, LA, CCN 190098
• Ochsner Lsu Health Shreveport-St Mary Medical Cent Hospital, Shreveport, LA, CCN 190317
• Ochsner Lsu Health Monroe Hospital, Monroe, LA, CCN 190011

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rkelley727261@direct.ochsner.org

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.

• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222

  Neurology

  Medicare reassignment Care Compare group NPD
• Administrators of the Tulane Educational Fund

  • Specialist
  • Covington, LA
  • NPI 1245434224
  Medicare reassignment NPD
• Administrators of the Tulane Educational Fund

  • Specialist
  • New Orleans, LA
  • NPI 1528014164
  Medicare reassignment NPD
• Administrators of the Tulane Educational Fund

  • Specialist
  • Hattiesburg, MS
  • NPI 1033395298
  NPD
• Administrators of the Tulane Education Fund

  • Anatomic Pathology & Clinical Pathology Physician
  • New Orleans, LA
  • NPI 1790354595
  NPD (past)
• Brfhh Shreveport LLC

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1912909912
  NPD (past)

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

• Brfhh Monroe LLC

  • General Acute Care Hospital
  • Monroe, LA
  • NPI 1215939210
  Care Compare affiliation
• Ochsner Lsu Health Shreveport - St. Mary Medical Center, LLC

  • Women's Hospital
  • Shreveport, LA
  • NPI 1285253252
  Care Compare affiliation
• University Health Shreveport LLC

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1427536325
  Care Compare affiliation

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1114943990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 S. ROBERTSON STREET, STE. 1300",
            "address_2": "CENTER FOR CLINICAL NEUROSCIENCES",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70112",
            "telephone_number": "504-988-1133",
            "fax_number": "504-988-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-626-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Kings Highway",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034228",
            "country_code": "US",
            "telephone_number": "318-675-7760",
            "fax_number": "318-675-6382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "ROGER",
        "middle_name": "EVERETT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "LA",
            "license": "013686",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "LA",
            "license": "MD.013686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1653071",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kacie Dore' Keith, PHARMD
• Lori Keith
• Katelyn Nicole Kellar
• Dwayne Keller, MD
• Hilary Rachel Keller, M.D.
• Shirley A Kelley, CRNA
• Tamra Kelley
• Kristi Lee Kellogg, PTA
• Lisa Nicole Kellogg, CRNA
• Marsha Kellum

• Vascular Neurology Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Vascular Neurology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.