John S Kilpatrick MD a Professional Medical Corporation

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

015694 Issued in LA

Legal business name

JOHN S KILPATRICK MD A PROFESSIONAL MEDICAL CORPORATION

Practice address

745 Olive St Ste 207
Shreveport, LA 71104-2250

Phone

(318) 216-3040

Fax

(318) 216-3614

NPI assigned

Sep 17, 2015

Organization subpart

No

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

Authorized official

Name

John Stephen Kilpatrick, MDNPI 1629187422

Title

President

Phone

(318) 216-3040

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Stephen Kilpatrick, MD

  • Nephrology Physician
  • Shreveport, LA
  • NPI 1629187422
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1386013670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 OLIVE ST STE 207",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042250",
            "telephone_number": "318-216-3040",
            "fax_number": "318-216-3614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 OLIVE ST STE 207",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042250",
            "telephone_number": "318-216-3040",
            "fax_number": "318-216-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN S KILPATRICK MD A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-17",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "KILPATRICK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-216-3040",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "015694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joedread Enterprises, LLC
• Jessica Joffrion
• Chase Johansen
• John H Wagner,III,MD,LLC
• John Moissidis MD and Willis-Knighton Medical Center
• Joseph Mullasseril John, D.O,
• Chantanell Johns
• Rachel Elizabeth Johns, MOT/L
• Johnson Behavioral Health Group
• Terrika Johnson-Dyer

• Nephrology Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Nephrology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.