Kendall Thomas Pilgreen, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.200647 Issued in LA

Practice address

1111 Line Ave 3Rd Floor
Tower 2
Shreveport, LA 71101

Phone

(318) 716-4610

Fax

(318) 716-4690

NPI assigned

Sep 16, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• WK Psychology Specialty Center

  • Clinical Psychologist
  • Shreveport, LA
  • NPI 1144543489
  NPD (past)
• WK Shreveport Center for Geriatric Health

  • Geriatric Psychiatry Physician
  • Shreveport, LA
  • NPI 1114256476
  NPD (past)

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1174959779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 LOUISIANA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013910",
            "telephone_number": "318-212-8574",
            "fax_number": "318-212-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 LINE AVE 3RD FLOOR",
            "address_2": "TOWER 2",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71101",
            "telephone_number": "318-716-4610",
            "fax_number": "318-716-4690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2508 Bert Kouns Industrial Loop",
            "address_2": "Suite 303",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711183133",
            "country_code": "US",
            "telephone_number": "318-212-5850",
            "fax_number": "318-212-5855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PILGREEN",
        "first_name": "KENDALL",
        "middle_name": "THOMAS",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pierremont Anesthesia Consultants
• Pierremont Center LLC
• Stephanie Nicole Pigott
• Kevin Lee Pike, DMIN, MDIV, BCC
• Micah Boyett Pilcher, C.P.N.P.
• Pill Box Pharmacy Incorporated
• Rhydonia R. Pillars, LMT, NCTMB
• Demetris Pillows
• Joney Pillows
• Paulette Pinargote Cornejo, M.D.

• Physician Assistant in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.