Kenner Physician Associates, LLC
Organization Active NPI Pediatrics Physician · Kenner, LA
NPI 1295887149 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1295887149
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 023871 (LA)
- Legal business name
- KENNER PHYSICIAN ASSOCIATES, LLC
- Practice address
- 200 W Esplanade Ave
Suite 106
Kenner, LA 70065-2489 - Phone
- (504) 712-7000
- Fax
- (504) 712-7040
- NPI assigned
- Jan 18, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Scott Brandon Simeon, M.D.
- Title
- Member
- Phone
- (504) 712-7000
Practitioners 2
-
Scott Brandon Simeon, M.D.
-
Michelle Mireille Davis, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 19D0987635 | Kenner Physician Associates, LLC | Provider-performed microscopy | Jun 10, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040623000047 | LA | Part B Supplier - Clinic/Group Practice | 9739164757 |
Receives reassigned benefits from 1 practitioner Practice locations: Kenner, LA |
National Provider Directory
Locations
200 W Esplanade Ave
Ste 405
Kenner, LA 70065
Phone (504) 305-3500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | 023871 | LA | |
| Pediatrics Physician |
208000000X | 023871 | LA | Yes |
Addresses
Primary practice location
200 W Esplanade Ave
Suite 106
Kenner, LA 70065-2489
Mailing address
200 W Esplanade Ave
Suite 106
Kenner, LA 70065-2489
Phone (504) 712-7000
Other providers in Kenner, LA
- Dakeitha Kelly
- Kenner Dental Associates, LLC
- Kenner Dental Company LLC
- Kenner Emergency Group LLC
- Kenner Outpatient Surgery Center
- James E Kerl
- KG Express Transportation, LLC
- Kamran Khan
- Kidney Counsultants LLC
- Angela W Kilbourn
All providers in Kenner, LA · Pediatrics Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.