Kellie Bourg Paddy, A.P.R.N.
Individual provider Active NPI Adult Health Nurse Practitioner · Leesville, LA
NPI 1154564169 · NPPES record last updated Feb 27, 2026
Key facts
- NPI
- 1154564169
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- RN105307-AP05784 (LA)
- Practice address
- 931 Verone Ter
Leesville, LA 71446-4272 - Phone
- (337) 404-1708
- Fax
- (337) 404-1709
- NPI assigned
- Apr 7, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2008
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Physical Therapy Services of West Louisiana Inc
West Louisiana Health Services Inc
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
- Elara Caring
- Beauregard Home Health
- Beauregard Memorial Hospital
- Byrd Regional Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211202000859 | LA | Practitioner - Nurse Practitioner | 6204069081 | Reassigns benefits to 7 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN105307-AP05784 | LA | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beauregard Family Medical Center, LLC | Current |
Accepting new patients | |
| West Louisiana Health Services Inc | Current |
Accepting new patients | |
| Beauregard Medical and Surgical Center, LLC | Current |
Accepting new patients | |
| Hospital Service District No 2 of Parish of Beauregard State of la | Current | Accepting new patients | |
| Beauregard Urology Center, LLC | Current |
Accepting new patients | |
| Beauregard Internal Medicine Center, LLC | Current |
Accepting new patients | |
| Beauregard Surgery Center, LLC | Current |
Accepting new patients | |
| Beauregard Women'S Health Center, LLC | Current |
Accepting new patients | |
| Chuen K Kwok Ms Apmc | Past |
Accepting new patients | |
| Beauregard Memorial Hospital Medical Staff Services | Past | Accepting new patients | |
| Sterling Medical Associates | Past | Accepting new patients | |
| Sterling Adult Day Services | Past | Accepting new patients |
Locations
501 S Pine St
Deridder, LA 70634
Phone (337) 462-3937
302 W 6th St
Deridder, LA 70634
Phone (337) 463-8556
600 S Pine St
Deridder, LA 70634
Phone (337) 462-7100
501 S Pine St
#C
Deridder, LA 70634
Phone (337) 463-9890
206 W 5th St
Deridder, LA 70634
Phone (337) 462-7106
301 S Washington St
Deridder, LA 70634
Phone (337) 460-7688
495 W 8th St
Deridder, LA 70634
Phone (337) 462-2262
316 W 7th St
Deridder, LA 70634
Phone (337) 462-1400
931 Verone Ter
Leesville, LA 71446
Phone (337) 238-0620
Interoperability endpoints
- kellie.paddy@beauregard.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | RN105307-AP05784 | LA | Yes |
Addresses
Primary practice location
931 Verone Ter
Leesville, LA 71446-4272
Mailing address
PO Box 730
Deridder, LA 70634-0730
Phone (337) 462-7138
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2572555 | Medicaid | LA |
Other providers in Leesville, LA
- Oluwayemisi Radiology LLC
- Carrie Ormsby
- Heather Lynne Ortego
- Orthopedic Center of la LLC
- Outpatient Medical Center, Inc.
- Panoptic PMR LLC
- Tava Joyel Parks
- Pearson Drugs No. 4, LLC
- Perfectly Polished Day Spa and Salon
- Dena L. Perkins
All providers in Leesville, LA · Adult Health Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.