Kenneth Patrick Powell, MD

Primary specialty

Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X

License

320573 Issued in LA

Practice address

3100 Samford Ave
Shreveport, LA 71103-4239

Phone

(318) 226-3306

Fax

(318) 226-3319

NPI assigned

Jul 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX, MS, LA3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222

  Orthopaedic Surgery

  Medicare reassignment NPD
• Shriners Hospitals for Children

  • Children's Hospital
  • Shreveport, LA
  • NPI 1679617849
  Medicare reassignment NPD
• Shriners Hospitals for Children

  • Pediatric Surgery Physician
  • Galveston, TX
  • NPI 1851631709
  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment NPD
• Shriners Hospitals for Children

  • Clinic/Center
  • Aiea, HI
  • NPI 1568299857
  NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD
• Ochsner Lsu Health Shreveport - St. Mary Medical Center, LLC

  • Women's Hospital
  • Shreveport, LA
  • NPI 1285253252
  NPD (past)
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Shriners Hospitals for Children

  • Orthopaedic Surgery Physician
  • Lexington, KY
  • NPI 1700223559
  NPD (past)

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1285833129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SAMFORD AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034239",
            "telephone_number": "318-226-3306",
            "fax_number": "318-226-3319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SAMFORD AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034239",
            "telephone_number": "318-226-3306",
            "fax_number": "318-226-3319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "KENNETH",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MS",
            "license": "T-1987",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "MD48720",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "TX",
            "license": "P7970",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "MS",
            "license": "23488",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "LA",
            "license": "320573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08129884",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Antoinette Stephens Powell
• Britney Jo Powell, NP
• Celeste Powell
• Deanna Lynn Powell, M.D.
• Kashanti Powell
• Kimberly Sue Powell, LPC
• Lamonica Powell
• Moranda Mone'T Powell, RN
• Rhonda Varnell Powell, CRNA
• Samantha Anne Powell, MA, PLPC

• Pediatric Orthopaedic Surgery Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Pediatric Orthopaedic Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.