NPIMap

Individual provider Active NPI

Kirk Elliott

  • Family Medicine Physician
  • Arnaudville, LA
National Provider Identifier
1639104169
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
023075 Issued in LA
Practice address
410 Olive St
Arnaudville, LA 70512-0187
Phone
(337) 754-7254
Fax
(337) 754-8047
NPI assigned
Jul 12, 2006
Last updated
May 30, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2008

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 023075 LA Primary

Addresses

Primary practice location

410 Olive St
Arnaudville, LA 70512-0187

Mailing address

PO Box 187
Arnaudville, LA 70512-0187
Phone (337) 754-7254

Other identifiers 1

IdentifierTypeStateIssuer
1491063MedicaidLA

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
I20050608000161 LA Practitioner - Family Practice 5395788616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kirk E Elliott MD LLCGroup PAC ID 8820037609, 2 clinicians

Practice addresses (Care Compare)

410 Olive St
Arnaudville, LA 70512-6154
Phone (337) 754-7254

PO Box
Suite 187
Arnaudville, LA 70512

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions17
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023075LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kirk E. Elliott, M.D. , LLC CurrentSince Apr 23, 2014 Accepting new patients
Teche Manor Nursing Home, LLC Past Accepting new patients
Opelousas General Hospital Authority Past Accepting new patients
Kirk E. Elliott M.D. LLC Family Medicine PastSince Jan 1, 2005 Accepting new patients

Locations

410 Olive St
Arnaudville, LA 70512
Phone (337) 754-7254

883 Main St
Arnaudville, LA 70512
Phone (337) 754-7703

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212105600000",
    "number": "1639104169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 187",
            "city": "ARNAUDVILLE",
            "state": "LA",
            "postal_code": "705120187",
            "telephone_number": "337-754-7254",
            "fax_number": "337-754-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 OLIVE ST",
            "city": "ARNAUDVILLE",
            "state": "LA",
            "postal_code": "705120187",
            "telephone_number": "337-754-7254",
            "fax_number": "337-754-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "KIRK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "023075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1491063",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arnaudville, LA

Sources for this page

Verify at the official NPI Registry.