Active NPI
Garrison Kendal Colvin, MD
- General Practice Physician
- Fort Johnson, LA
National Provider Identifier
1447937503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 34504
- Practice address
- 1585 3Rd St
Fort Johnson, LA 71459-5102 - Phone
- (337) 531-0289
- NPI assigned
- Jun 30, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 34504 | WV | Primary |
Addresses
Primary practice location
1585 3Rd St
Fort Johnson, LA 71459-5102
Mailing address
6618 Jordan CT Apt B
Fort Johnson, LA 71459-3282
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34504 | WV | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730678400000",
"number": "1447937503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6618 JORDAN CT APT B",
"city": "FORT JOHNSON",
"state": "LA",
"postal_code": "714593282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1585 3RD ST",
"city": "FORT JOHNSON",
"state": "LA",
"postal_code": "714595102",
"telephone_number": "337-531-0289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLVIN",
"first_name": "GARRISON",
"middle_name": "KENDAL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-30",
"last_updated": "2024-11-04",
"certification_date": "2024-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "WV",
"license": "34504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Johnson, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.