Active NPI
Kelly R Romero, NNP
- Nurse Practitioner
- Lafayette, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP05822
- Practice address
- 4600 Ambassador Caffery Pkwy
Lafayette, LA 70508-6902 - Phone
- (337) 470-5634
- Fax
- (337) 521-9128
- NPI assigned
- Aug 29, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 2646 | SC | |
| Nurse Practitioner | 363L00000X | AP05822 | LA | Primary |
Addresses
Primary practice location
4600 Ambassador Caffery Pkwy
Lafayette, LA 70508-6902
Mailing address
5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (337) 470-5634
Other practice location 1
171 Ashley Ave
Charleston, SC 29425-0001
Phone (843) 792-1414
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NP0912 | Medicaid | SC |
Other names 1
- Kelly I Roscoe
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2646 | SC | MD | Physical Therapy Assistant |
| AP05822 | LA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lourdes Physician Group LLC | Nurse Practitioner | Current | Accepting new patients |
Locations
5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011
4600 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 371-3135
4801 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 470-2000
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Lafayette, LA
- NPI 1437405883
Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727395200000",
"number": "1295843167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5959 S SHERWOOD FOREST BLVD",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708166038",
"telephone_number": "337-470-5634",
"fax_number": "225-765-6916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 AMBASSADOR CAFFERY PKWY",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705086902",
"telephone_number": "337-470-5634",
"fax_number": "337-521-9128"
}
],
"practiceLocations": [
{
"address_1": "171 Ashley Ave",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "SC",
"postal_code": "294250001",
"country_code": "US",
"telephone_number": "843-792-1414",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROMERO",
"first_name": "KELLY",
"middle_name": "R",
"credential": "NNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-29",
"last_updated": "2024-09-27",
"certification_date": "2024-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "SC",
"license": "2646",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "LA",
"license": "AP05822",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NP0912",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "ROSCOE",
"middle_name": "I",
"credential": "NNP",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.