Individual provider Active NPI

Kimberly Kornegay, FNP

  • Family Nurse Practitioner
  • West Monroe, LA
National Provider Identifier
1417328824
Registry record updated Oct 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP08530 Issued in LA
Practice address
1107 Glenwood Dr
West Monroe, LA 71291-5503
Phone
(318) 396-3800
Fax
(318) 323-1511
NPI assigned
Oct 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP08530 LA Primary

Addresses

Primary practice location

1107 Glenwood Dr
West Monroe, LA 71291-5503

Mailing address

1107 Glenwood Dr
West Monroe, LA 71291-5503
Phone (318) 396-3800

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160209000416 LA Practitioner - Nurse Practitioner 3476722661 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Francis Urgent Care LLCGroup PAC ID 6608181516, 11 clinicians

Practice addresses (Care Compare)

2020 Tower Dr
Suite 100
Monroe, LA 71201-5036
Phone (318) 966-6220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Group of Louisiana Inc CurrentSince Nov 15, 2015 Accepting new patients
Northern Louisiana Emergency Physicians, LLP CurrentSince Oct 4, 2017 Accepting new patients
Healthcare Plus Limited Liability Company CurrentSince Dec 1, 2022 Accepting new patients
St. Francis Urgent Care LLC CurrentSince Oct 20, 2018 Accepting new patients
Physician Group of Louisiana Inc CurrentSince Nov 15, 2015 Accepting new patients
Northern Louisiana Emergency Physicians LLP CurrentSince Oct 4, 2017 Accepting new patients

Locations

2020 Tower Dr
Ste 100
Monroe, LA 71201
Phone (318) 966-6220

401 E Vaughn Ave
Ruston, LA 71270
Phone (318) 254-2100

503 McMillan Rd
Fl 2
West Monroe, LA 71291
Phone (318) 329-3475

3424 Cypress St
West Monroe, LA 71291
Phone (318) 450-4626

1900 N 7th St
West Monroe, LA 71291
Phone (318) 322-8535

1107 Glenwood Dr
West Monroe, LA 71291
Phone (318) 340-1003

778 Liberty Rd
Flowood, MS 39232
Phone (601) 914-9620

Interoperability endpoints

  • Direct secure messaging: kkornegay4135075@direct.casso.us.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444608000000",
    "number": "1417328824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 GLENWOOD DR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915503",
            "telephone_number": "318-396-3800",
            "fax_number": "318-323-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 GLENWOOD DR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915503",
            "telephone_number": "318-396-3800",
            "fax_number": "318-323-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNEGAY",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-12",
        "last_updated": "2015-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP08530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Monroe, LA

Sources for this page

Verify at the official NPI Registry.