Kenneth John Mekelburg, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

13801R Issued in LA

Practice address

2525 Viking Drive
Bossier City, LA 71111-2103

Phone

(318) 841-2525

Fax

(318) 681-6812

NPI assigned

Jul 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Internal Medicine

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

WK Bossier HospitalistsGroup PAC ID 4486729639, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Primestar Home Health of Nwla, Inc Home health agency, Minden, LA, CCN 197446
• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111
• Intensive Specialty Hospital Inpatient rehabilitation facility, Shreveport, LA, CCN 19TA10
• Intensive Specialty Hospital Long-term care hospital, Shreveport, LA, CCN 192010

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• WK Bossier Hospitalists

  • Hospitalist Physician
  • Bossier City, LA
  • NPI 1487815866
  Medicare reassignment Care Compare group NPD
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  NPD (past)

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

• Intensive Specialty Hospital, LLC

  dba Intensive Specialty Hospital

  • Long Term Care Hospital
  • Shreveport, LA
  • NPI 1528622065

  Inpatient rehabilitation facility

  Care Compare affiliation
• Intensive Specialty Hospital, LLC

  dba North Louisiana Whole Health Treatment Center

  • Adult Mental Health Clinic/Center
  • Shreveport, LA
  • NPI 1598344848

  Long-term care hospital

  Care Compare affiliation
• Intensive Specialty Hospital, LLC

  • Rehabilitation Hospital Unit
  • Shreveport, LA
  • NPI 1770365009

  Inpatient rehabilitation facility

  Care Compare affiliation
• Primestar Home Health of Nwla Inc

  • Home Health Agency
  • Minden, LA
  • NPI 1952350456
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba WK Bossier Health Center

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba Willis Knighton South Hospital

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba WK Pierremont Health Center

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  Care Compare affiliation

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1619975166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 VIKING DRIVE",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112103",
            "telephone_number": "318-841-2525",
            "fax_number": "318-681-6812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 VIKING DRIVE",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112103",
            "telephone_number": "318-841-2525",
            "fax_number": "318-681-6812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEKELBURG",
        "first_name": "KENNETH",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "13801R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1436836",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Medical Infusion Therapy of la
• Medical Masterz Courier and Transport LLC
• Medication Management Consultants LLC (Medication Management Consultants)
• Medivue LLC (Dr TUSHAR PAWAR)
• Medrx Specialty Pharmacy, LLC. (MedRx Pharmacy)
• Melanie Smith MD and Willis-Knighton Medical Center
• Melosa Foundation
• Casey Danielle Mendieta
• Mercier & Associates, Inc. (Janey Macey & Associates)
• Cheynita Metoyer, MD

• Internal Medicine Physician in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.