Individual provider Active NPI

Keenan Timothy Hurst Jr., MD

  • Surgery Physician
  • New Orleans, LA
National Provider Identifier
1558165696
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
347019 Issued in LA
Practice address
2021 Perdido St # 8F
New Orleans, LA 70112-1352
Phone
(504) 568-7912
NPI assigned
Apr 1, 2025
Last updated
Jun 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 347019 LA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2021 Perdido St # 8F
New Orleans, LA 70112-1352

Mailing address

1 Veeda CT
River Ridge, LA 70123-2082
Phone (504) 259-0400

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
I20250611000470 LA Order and Referring Only - General SurgeryPractitioner - General Surgery 9234649955

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
347019LAMDSurgery Physician

Interoperability endpoints

  • Direct secure messaging: khurst5338041@direct.casso.us.com

NPI Registry JSON

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

{
    "created_epoch": "1743465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1558165696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 VEEDA CT",
            "city": "RIVER RIDGE",
            "state": "LA",
            "postal_code": "701232082",
            "telephone_number": "504-259-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 PERDIDO ST # 8F",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701121352",
            "telephone_number": "504-568-7912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURST",
        "first_name": "KEENAN",
        "middle_name": "TIMOTHY",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "347019",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.