Individual provider Active NPI

Kellie Bourg Paddy, A.P.R.N.

  • Adult Health Nurse Practitioner
  • Leesville, LA
National Provider Identifier
1154564169
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN105307-AP05784 Issued in LA
Practice address
931 Verone Ter
Leesville, LA 71446-4272
Phone
(337) 404-1708
Fax
(337) 404-1709
NPI assigned
Apr 7, 2009
Last updated
Feb 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN105307-AP05784 LA Primary

Addresses

Primary practice location

931 Verone Ter
Leesville, LA 71446-4272

Mailing address

PO Box 730
Deridder, LA 70634-0730
Phone (337) 462-7138

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
I20211202000859 LA Practitioner - Nurse Practitioner 6204069081 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Physical Therapy Services of West Louisiana IncGroup PAC ID 0446388763, 92 clinicians
West Louisiana Health Services IncGroup PAC ID 5799680245, 9 clinicians

Practice addresses (Care Compare)

301 W Fertitta Blvd
Suite 4
Leesville, LA 71446-4665
Phone (337) 238-9931

931 Verone Ter
Leesville, LA 71446-4272
Phone (337) 404-1708

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN105307-AP05784LAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beauregard Surgery Center, LLC CurrentSince Oct 1, 2021 Accepting new patients
West Louisiana Health Services Inc CurrentSince Oct 1, 2021 Accepting new patients
Beauregard Medical and Surgical Center, LLC CurrentSince Oct 1, 2021 Accepting new patients
Beauregard Family Medical Center, LLC CurrentSince Oct 1, 2021 Accepting new patients
Beauregard Internal Medicine Center, LLC CurrentSince Oct 1, 2021 Accepting new patients
Beauregard Women's Health Center, LLC CurrentSince Oct 1, 2021 Accepting new patients
Hospital Service District No 2 of Parish of Beauregard State of la Current Accepting new patients
Beauregard Urology Center, LLC CurrentSince Oct 1, 2021 Accepting new patients
Sterling Medical Associates Past Accepting new patients
Sterling Adult Day Services Past Accepting new patients
Chuen K Kwok Ms Apmc PastSince Oct 1, 2021 Accepting new patients
Beauregard Memorial Hospital Medical Staff Services Past Accepting new patients

Locations

206 W 5th St
Deridder, LA 70634
Phone (337) 462-7106

301 S Washington St
Deridder, LA 70634
Phone (337) 460-7688

302 W 6th St
Deridder, LA 70634
Phone (337) 463-8556

316 W 7th St
Deridder, LA 70634
Phone (337) 462-1400

495 W 8th St
Deridder, LA 70634
Phone (337) 462-2262

501 S Pine St
Deridder, LA 70634
Phone (337) 462-3937

501 S Pine St
#C
Deridder, LA 70634
Phone (337) 463-9890

600 S Pine St
Deridder, LA 70634
Phone (337) 462-7100

931 Verone Ter
Leesville, LA 71446
Phone (337) 238-3475

Interoperability endpoints

  • Direct secure messaging: kellie.paddy@beauregard.medalliesdirect.net

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 4

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": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1154564169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 730",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706340730",
            "telephone_number": "337-462-7138",
            "fax_number": "337-462-7435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 VERONE TER",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464272",
            "telephone_number": "337-404-1708",
            "fax_number": "337-404-1709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADDY",
        "first_name": "KELLIE",
        "middle_name": "BOURG",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-07",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "LA",
            "license": "RN105307-AP05784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesville, LA

Sources for this page

Verify at the official NPI Registry.