Kailey Claire Mataconis Dodson, MSN, APRN, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

210588 Issued in LA

Practice address

2449 Hospital Dr Ste 200
Bossier City, LA 71111-1905

Phone

(318) 212-7841

Fax

(318) 212-7846

NPI assigned

Aug 17, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

WK Bossier Orthopedic and SportsGroup PAC ID 6406951078, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

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 Orthopedic & Sports

  • Orthopaedic Surgery Physician
  • Bossier City, LA
  • NPI 1588715791
  Medicare reassignment Care Compare group NPD

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

• 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": "1723852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1649002619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2449 HOSPITAL DR STE 200",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711111905",
            "telephone_number": "318-212-7841",
            "fax_number": "318-212-7846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2449 HOSPITAL DR STE 200",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711111905",
            "telephone_number": "318-212-7841",
            "fax_number": "318-212-7846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODSON",
        "first_name": "KAILEY",
        "middle_name": "CLAIRE MATACONIS",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-17",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "210588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Distinct Home Health Care Inc (Samaritan Home Medical Equipment)
• Elsie Mary Dittman, LPC
• Divine Staffing Solutions II LC (Devoted Transportation Services)
• Sharon Dixon
• DJ Alex Rehabilitative Care LLC
• Kate Doherty, P.T., D.P.T
• Timothy Joseph Doherty, RPH
• Katelyn Donaldson, MA, CCC-SLP
• Donna Ann Walker
• Elizabeth Michelle Doolittle, PA-C

• Nurse Practitioner in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.