Individual provider Active NPI

Kristy H Cory, PAC

  • Physician Assistant
  • Shreveport, LA
National Provider Identifier
1659464865
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAA10364 Issued in LA
Practice address
2551 Greenwood Road
Suite 210
Shreveport, LA 71103-3905
Phone
(318) 635-0834
Fax
(318) 636-2331
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAA10364 LA Primary

Addresses

Primary practice location

2551 Greenwood Road
Suite 210
Shreveport, LA 71103-3905

Mailing address

2551 Greenwood Road
Suite 210
Shreveport, LA 71103-3905
Phone (318) 635-0834

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051020000704 LA Practitioner - Physician Assistant 9638195407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WK North Pulmonary and Critical CareGroup PAC ID 1759382856, 22 clinicians

Practice addresses (Care Compare)

1202 Louisiana Ave
Shreveport, LA 71101-3910
Phone (318) 635-0834

2600 Greenwood Rd
Shreveport, LA 71103-3908

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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 4

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659464865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2551 GREENWOOD ROAD",
            "address_2": "SUITE 210",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033905",
            "telephone_number": "318-635-0834",
            "fax_number": "318-636-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 GREENWOOD ROAD",
            "address_2": "SUITE 210",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033905",
            "telephone_number": "318-635-0834",
            "fax_number": "318-636-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORY",
        "first_name": "KRISTY",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PAA10364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.