NPIMap

Individual provider Active NPI

Kelvin Ellis Jr., D.O.

  • Emergency Medicine Physician
  • Zachary, LA
National Provider Identifier
1407340441
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
346884 Issued in LA
Practice address
6300 Main St
Zachary, LA 70791-4037
Phone
(225) 658-4316
NPI assigned
Jun 21, 2018
Last updated
Mar 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 346884 LA Primary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 315779 NY

Addresses

Primary practice location

6300 Main St
Zachary, LA 70791-4037

Mailing address

3600 Forbes Ave
Pittsburgh, PA 15213-3410

Other practice location 1

501 Howard Avenue
Suite F2
Altoona, PA 16601
Phone (814) 889-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, KY, LA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220728002997 NY Practitioner - Emergency Medicine 9234486390 Reassigns benefits to 1 organization
I20250828000513 KY Practitioner - Emergency Medicine 9234486390 Reassigns benefits to 1 organization
I20251118000377 LA Practitioner - Emergency Medicine 9234486390 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vincent Emergency Group, LLCGroup PAC ID 0840621926, 43 clinicians
Fep of Kentucky LLCGroup PAC ID 8123473626, 21 clinicians
Buffalo Emergency Associates LLPGroup PAC ID 4981502515, 54 clinicians
Acs Primary Care Physicians Louisiana PCGroup PAC ID 4486566932, 24 clinicians

Practice addresses (Care Compare)

100 Medical Ctr Dr
Slidell, LA 70461-5520
Phone (985) 649-7070

320 W 18TH St
Hopkinsville, KY 44240-1965
Phone (505) 287-4446

565 Abbott Rd
Buffalo, NY 14220-2039
Phone (716) 826-7000

6300 Main St
Zachary, LA 70791-4037
Phone (225) 658-4335

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
346884LAMDEmergency Medicine Physician
315779NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians Louisiana PC Emergency Medicine CurrentSince Dec 1, 2025 Accepting new patients
Buffalo Emergency Associates LLP Emergency Medicine CurrentSince Jul 15, 2022 Accepting new patients
Vincent Emergency Group, LLC Emergency Medicine CurrentSince Oct 1, 2025 Accepting new patients
Fep of Kentucky LLC Emergency Medicine CurrentSince Aug 1, 2025 Accepting new patients

Locations

320 W 18th St
Hopkinsville, KY 42240
Phone (270) 887-0100

211 4th St
Alexandria, LA 71301
Phone (318) 473-3000

100 Medical Center Dr
Slidell, LA 70461
Phone (504) 392-3131

1001 Gause Blvd
Slidell, LA 70458
Phone (985) 280-2200

6300 Main St
Zachary, LA 70791
Phone (225) 570-2618

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

2605 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 891-2315

Organizations & group practices 4

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1407340441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 FORBES AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152133410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 MAIN ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707914037",
            "telephone_number": "225-658-4316"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Howard Avenue",
            "address_2": "Suite F2",
            "address_purpose": "LOCATION",
            "city": "Altoona",
            "state": "PA",
            "postal_code": "16601",
            "country_code": "US",
            "telephone_number": "814-889-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KELVIN",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-21",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "346884",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "315779",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zachary, LA

Sources for this page

Verify at the official NPI Registry.