Individual provider Active NPI

Bruce P. Kerry, MD

  • Emergency Medicine Physician
  • Lacombe, LA
National Provider Identifier
1508809005
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
018492 Issued in LA
Practice address
64030 Highway 434
Lacombe, LA 70445-3456
Phone
(985) 892-4350
NPI assigned
Jun 13, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 018492 LA Primary

Addresses

Primary practice location

64030 Highway 434
Lacombe, LA 70445-3456

Mailing address

200 Corporate Blvd
Suite 201
Lafayette, LA 70508-3870
Phone (800) 893-9698

Other identifiers 1

IdentifierTypeStateIssuer
1357839MedicaidLA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050310000020 LA Practitioner - Emergency Medicine 8820042054 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018492LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Emergency Group LLC Emergency Medicine CurrentSince Feb 7, 2017 Accepting new patients
St. Bernard Emergency Group, LLC Emergency Medicine CurrentSince Apr 3, 2017 Accepting new patients

Locations

8000 W Judge Perez Dr
Chalmette, LA 70043
Phone (504) 493-6078

1900 W Airline Hwy
La Place, LA 70068
Phone (985) 652-7000

200 Corporate Blvd
Ste 201
Lafayette, LA 70508

Organizations & group practices 2

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1508809005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "address_2": "SUITE 201",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64030 HIGHWAY 434",
            "city": "LACOMBE",
            "state": "LA",
            "postal_code": "704453456",
            "telephone_number": "985-892-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERRY",
        "first_name": "BRUCE",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "018492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1357839",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacombe, LA

Sources for this page

Verify at the official NPI Registry.