Angela D Kennerly, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

229265 Issued in LA

Practice address

213 W Main St
New Roads, LA 70760-3511

Phone

(225) 242-9162

Fax

(833) 972-7844

NPI assigned

Jan 25, 2023

Last updated

Mar 18, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Louisiana Stat Care LLCGroup PAC ID 3870028491, 17 clinicians

New Roads Family Practice LLCGroup PAC ID 0143662825, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: angela.kennerly.1@28918.direct.athenahealth.com

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.

• Louisiana Stat Care LLC

  • General Practice Physician
  • Baton Rouge, LA
  • NPI 1891517512
  Medicare reassignment Care Compare group NPD
• New Roads Family Practice LLC

  • Rural Health Clinic/Center
  • New Roads, LA
  • NPI 1366204182

  Family Medicine

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1275249088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 477",
            "city": "GEISMAR",
            "state": "LA",
            "postal_code": "707340477",
            "telephone_number": "225-242-9162",
            "fax_number": "225-495-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 W MAIN ST",
            "city": "NEW ROADS",
            "state": "LA",
            "postal_code": "707603511",
            "telephone_number": "225-242-9162",
            "fax_number": "833-972-7844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNERLY",
        "first_name": "ANGELA",
        "middle_name": "D",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-25",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "229265",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "229265",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laticia K Johnson, CF-SLP
• Victoria Joubert, LCSW
• Just Health
• Just Health
• Lacie Ourso Kemp
• Erica Noel Kimble
• Lisa Ann King, FNP
• Katie Lacour, PT, DPT
• Lakeview Manor Inc
• Lakeview Manor Nursing and Rehabilitation Center, LLC (Lakeview Manor Nursing and Rehabilitation)

• Family Nurse Practitioner in New Roads, LA
• Providers in New Roads, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.