NPIMap

Individual provider Active NPI

Kayla R Fung, APRN

  • Acute Care Nurse Practitioner
  • Alexandria, LA
National Provider Identifier
1609122688
Registry record updated Jan 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP06996 Issued in LA
Practice address
3330 Masonic Dr
Alexandria, LA 71301-3841
Phone
(318) 448-6700
NPI assigned
Jul 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP06996 LA Primary
Nurse Practitioner 363L00000X AP06996 LA

Addresses

Primary practice location

3330 Masonic Dr
Alexandria, LA 71301-3841

Mailing address

919 Hidden RDG
Irving, TX 75038-3813
Phone (469) 282-2711

Other identifiers 1

IdentifierTypeStateIssuer
2330543MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130926000845 LA Practitioner - Nurse Practitioner 2466696745 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Louisiana Intensivists LLCGroup PAC ID 6002346566, 12 clinicians

Practice addresses (Care Compare)

3330 Masonic Dr
Alexandria, LA 71301-3841
Phone (318) 487-1122

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alexandria Gastrointestinal Specialists, LLC CurrentSince Apr 1, 2016 Accepting new patients
Central Louisiana Physicians, LLC Nurse Practitioner CurrentSince Feb 28, 2024 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 1, 2020 Accepting new patients
Christus Health Central Louisiana CurrentSince Jul 17, 2015 Accepting new patients
Central Louisiana Intensivists LLC Nurse Practitioner CurrentSince Mar 1, 2025 Accepting new patients
Christus Health Central Louisiana CurrentSince Jul 17, 2015 Accepting new patients
C H Wilkinson Physician Network Nurse Practitioner CurrentSince Jul 13, 2013 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 1, 2020 Accepting new patients

Locations

3330 Masonic Dr
Alexandria, LA 71301
Phone (318) 448-6917

3311 Prescott Rd
Ste 411
Alexandria, LA 71301
Phone (318) 448-5310

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

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

Interoperability endpoints

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

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483315200000",
    "number": "1609122688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 HIDDEN RDG",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383813",
            "telephone_number": "469-282-2711",
            "fax_number": "469-282-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 MASONIC DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013841",
            "telephone_number": "318-448-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNG",
        "first_name": "KAYLA",
        "middle_name": "R",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-27",
        "last_updated": "2017-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "AP06996",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP06996",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2330543",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.