Individual provider Active NPI

Kimberly Roshelle Coney, FNP

  • Nurse Practitioner
  • Roseland, LA
National Provider Identifier
1124638036
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
215034 Issued in LA
Practice address
62112 Bennett Rd
Roseland, LA 70456-1706
Phone
(985) 510-1382
NPI assigned
Aug 5, 2020
Last updated
Jul 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 215034 LA Primary
Family Nurse Practitioner 363LF0000X 215034 LA

Addresses

Primary practice location

62112 Bennett Rd
Roseland, LA 70456-1706

Mailing address

PO Box 1268
Amite, LA 70422-1268

Other practice location 1

5439 Airline Hwy
Baton Rouge, LA 70805-1712
Phone (225) 358-4855

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
I20211104000540 LA Practitioner - Nurse Practitioner 4385032747 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Oaks Physician Group LLCGroup PAC ID 9133378870, 62 clinicians

Practice addresses (Care Compare)

42205 Veterans Ave
Hammond, LA 70403-1424
Phone (985) 230-5630

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
215034LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Oaks Physician Group, LLC CurrentSince May 1, 2025 Accepting new patients
Convenient Care LLC CurrentSince Oct 27, 2021 Accepting new patients
LCMC Urgent Care LLC CurrentSince Oct 27, 2021 Accepting new patients
Convenient Care LLC CurrentSince Oct 27, 2021 Accepting new patients
North Oaks Physician Group, LLC CurrentSince May 1, 2025 Accepting new patients
North Oaks Medical Center, LLC CurrentSince May 30, 2025 Accepting new patients
North Oaks Medical Center, LLC CurrentSince May 1, 2025 Accepting new patients

Locations

12525 Perkins Rd
Baton Rouge, LA 70810
Phone (225) 765-6800

12525 Perkins Rd
#B
Baton Rouge, LA 70810
Phone (225) 819-8857

14158 University Ave
Hammond, LA 70401
Phone (985) 230-5640

15790 Paul Vega Md Dr
Hammond, LA 70403
Phone (985) 230-1682

15813 Paul Vega Md Dr
Ste 200
Hammond, LA 70403
Phone (985) 230-7650

1900 S Morrison Blvd
Ste A
Hammond, LA 70403
Phone (985) 230-5726

42205 Veterans Ave
Hammond, LA 70403
Phone (985) 230-5630

2600 Belle Chasse Hwy
Ste B2
Terrytown, LA 70056
Phone (504) 309-7108

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1124638036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1268",
            "city": "AMITE",
            "state": "LA",
            "postal_code": "704221268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62112 BENNETT RD",
            "city": "ROSELAND",
            "state": "LA",
            "postal_code": "704561706",
            "telephone_number": "985-510-1382"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5439 Airline Hwy",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708051712",
            "country_code": "US",
            "telephone_number": "225-358-4855",
            "fax_number": "225-358-2350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONEY",
        "first_name": "KIMBERLY",
        "middle_name": "ROSHELLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "215034",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "215034",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseland, LA

Sources for this page

Verify at the official NPI Registry.