Individual provider Active NPI

Edmond Kalifey, MD

  • Family Medicine Physician
  • Marksville, LA
National Provider Identifier
1568464790
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
008927 Issued in LA
Practice address
137 Dr. Childress Dr.
Marksville, LA 71351
Phone
(318) 256-3332
Fax
(318) 409-4040
NPI assigned
Jun 1, 2005
Last updated
Feb 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 008927 LA Primary

Addresses

Primary practice location

137 Dr. Childress Dr.
Marksville, LA 71351

Mailing address

P.O. Box 97
Marksville, LA 71351
Phone (504) 258-8340

Other identifiers 2

IdentifierTypeStateIssuer
1062791MedicaidLA
1943681MedicaidLA

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
I20031111000474 LA Practitioner - Family Practice 4183535743 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 1961
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Compass Mental Health MD, LLCGroup PAC ID 7911056742, 16 clinicians

Practice addresses (Care Compare)

6410 Masonic Dr
Alexandria, LA 71301-2319
Phone (318) 442-3163

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008927LAMDFamily Medicine Physician
8927LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Behavioral Center of Alexandria, LLC CurrentSince Feb 16, 2020 Accepting new patients
C H Wilkinson Physician Network Family Medicine CurrentSince Apr 7, 2013 Accepting new patients
Compass Mental Health MD, LLC CurrentSince Nov 17, 2019 Accepting new patients
C H Wilkinson Physician Network CurrentSince Apr 7, 2013 Accepting new patients
Diana L. Corley, FNP, LLC PastSince Feb 16, 2020 Accepting new patients

Locations

2108 Texas Ave
Ste 3080
Alexandria, LA 71301
Phone (318) 442-5758

6410 Masonic Dr
Alexandria, LA 71301
Phone (318) 442-3163

713 N Avenue L
Crowley, LA 70526
Phone (337) 783-2859

137 Dr Childress Dr
Marksville, LA 71351
Phone (318) 256-3332

5541 Highway 1
Marksville, LA 71351
Phone (318) 240-7240

1 Saint Mary Pl
Shreveport, LA 71101
Phone (318) 681-4500

919 Hidden Rdg
Irving, TX 75038

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4

Organizations & group practices 5

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1568464790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 97",
            "city": "MARKSVILLE",
            "state": "LA",
            "postal_code": "71351",
            "telephone_number": "504-258-8340",
            "fax_number": "318-409-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 DR. CHILDRESS DR.",
            "city": "MARKSVILLE",
            "state": "LA",
            "postal_code": "71351",
            "telephone_number": "318-256-3332",
            "fax_number": "318-409-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALIFEY",
        "first_name": "EDMOND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "008927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1062791",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1943681",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marksville, LA

Sources for this page

Verify at the official NPI Registry.