Individual provider Active NPI

Abigale Heather Dawn Kavanagh, MD

  • Family Medicine Physician
  • New Orleans, LA
National Provider Identifier
1174019384
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
327845 Issued in LA
Practice address
4710 S Carrollton Ave
New Orleans, LA 70119-6027
Phone
(504) 454-9020
NPI assigned
Jul 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 327845 LA Primary

Addresses

Primary practice location

4710 S Carrollton Ave
New Orleans, LA 70119-6027

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (504) 454-9020

Other practice location 1

1501 Kings Highway
Family Medicine
Shreveport, LA 71130
Phone (318) 626-0014

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210708001836 LA Practitioner - Family Practice 6406106194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1174019384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "504-454-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 S CARROLLTON AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701196027",
            "telephone_number": "504-454-9020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Kings Highway",
            "address_2": "Family Medicine",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "71130",
            "country_code": "US",
            "telephone_number": "318-626-0014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAVANAGH",
        "first_name": "ABIGALE",
        "middle_name": "HEATHER DAWN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-11",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "327845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.