Individual provider Active NPI

Laurie M. Kinchen, CPNP,CNS

  • Pediatric Nurse Practitioner
  • Livingston, LA
National Provider Identifier
1497754899
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP04682 Issued in LA
Practice address
29565 S Frost Rd Ste C
Livingston, LA 70754-1903
Phone
(225) 686-1114
Fax
(225) 686-1166
NPI assigned
Jul 18, 2005
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP04682 LA Primary

Addresses

Primary practice location

29565 S Frost Rd Ste C
Livingston, LA 70754-1903

Mailing address

PO Box 1567
Livingston, LA 70754-1567
Phone (225) 686-1114

Other identifiers 1

IdentifierTypeStateIssuer
1623156MedicaidLA

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
I20240826003978 LA Practitioner - Nurse Practitioner 9931648649 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Certified Pediatric Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stewart Medical & Urgent Care, LLC CurrentSince Aug 12, 2024 Accepting new patients

Locations

29565 S Frost Rd
Ste C
Livingston, LA 70754
Phone (225) 686-1114

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1497754899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1567",
            "city": "LIVINGSTON",
            "state": "LA",
            "postal_code": "707541567",
            "telephone_number": "225-686-1114",
            "fax_number": "225-686-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29565 S FROST RD STE C",
            "city": "LIVINGSTON",
            "state": "LA",
            "postal_code": "707541903",
            "telephone_number": "225-686-1114",
            "fax_number": "225-686-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCHEN",
        "first_name": "LAURIE",
        "middle_name": "M.",
        "credential": "CPNP,CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "LA",
            "license": "AP04682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1623156",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, LA

Sources for this page

Verify at the official NPI Registry.