Kelli Spillers Bovard, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN103455 AP04901 Issued in LA

Practice address

8415 Goodwood Blvd
Suite 104
Baton Rouge, LA 70806-7851

Phone

(225) 925-9797

Fax

(225) 925-9787

NPI assigned

Jun 12, 2006

Last updated

Jan 20, 2021By 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 1

Addresses

Other identifiers 1

Other names 1

• Kelli Michelle Spillers Former name

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbovard2626@direct.casso.us.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.

• Our Lady of the Lake Physician Group LLC

  • Internal Medicine Physician
  • Baton Rouge, LA
  • NPI 1033494943

  Nurse Practitioner

  Medicare reassignment NPD
• Our Lady of the Lake Physician Group LLC

  dba Our Lady of the Lake Children's Health Developmental Center at McMains

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Baton Rouge, LA
  • NPI 1235912502
  NPD
• Our Lady of the Lake Physician Group, LLC

  • Urgent Care Clinic/Center
  • Baton Rouge, LA
  • NPI 1588062079
  NPD
• Our Lady of the Lake Hospital Inc

  dba Lake Primary Care Physicians

  • Internal Medicine Physician
  • Baton Rouge, LA
  • NPI 1275577603
  NPD (past)
• Our Lady of the Lake Physician Group LLC

  dba OLOL Physician Surgical Specialty

  • Hematology & Oncology Physician
  • Baton Rouge, LA
  • NPI 1184671455

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1316989650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 GOODWOOD BLVD",
            "address_2": "SUITE 104",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708067851",
            "telephone_number": "225-925-9797",
            "fax_number": "225-925-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8415 GOODWOOD BLVD",
            "address_2": "SUITE 104",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708067851",
            "telephone_number": "225-925-9797",
            "fax_number": "225-925-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVARD",
        "first_name": "KELLI",
        "middle_name": "SPILLERS",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "LA",
            "license": "RN103455 AP04901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1527467",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epihosted.com/FHIRPoxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "8415 Goodwood Blvd",
            "address_2": "Suite 104",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708067851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbovard2626@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kbovard2626@direct.casso.us.com",
            "address_1": "8415 Goodwood Blvd",
            "address_2": "Suite 104",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708067851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "SPILLERS",
            "middle_name": "MICHELLE",
            "credential": "CPNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rikki F Bourque, APRN, CPNP
• Taylor Bourque, LPC
• Kelly Eaton Boussert, M.D.
• Sheidra Traveler Boutte, LCSW
• Denise Ann Bouvier, APRN, FNP-C
• Bethany B Bowden, N.P.
• Suzette M Bowen, LPC
• Amanda Michelle Bowers
• Charles Rodney Bowie, M.D.
• Marah Bowie

• Pediatric Nurse Practitioner in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Pediatric Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; 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.