Kristy A Kehoe, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

200338 Issued in LA

Practice address

5400 E. Texas St
Bossier City, LA 71111

Phone

(318) 675-1313

Fax

(888) 965-0619

NPI assigned

Mar 16, 2010

Last updated

Dec 16, 2022By the provider in NPPES

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

Other identifiers 1

Other names 1

• Kristy M Addison Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Synergy International Healthcare Services, Inc.

  • Primary Care Clinic/Center
  • Bossier City, LA
  • NPI 1598475246
  Medicare reassignment
• WK River Cities Interventional Pain

  • Pain Medicine (Anesthesiology) Physician
  • Shreveport, LA
  • NPI 1962447052
  NPD (past)

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

{
    "created_epoch": "1268697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1669796926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 E. TEXAS ST",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "71111",
            "telephone_number": "318-675-1313",
            "fax_number": "888-965-0619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 E. TEXAS ST",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "71111",
            "telephone_number": "318-675-1313",
            "fax_number": "888-965-0619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEHOE",
        "first_name": "KRISTY",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-16",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "200338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1823007",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTY",
            "last_name": "ADDISON",
            "middle_name": "M",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kambri S Healthcare LLC
• Annette Renee Kane, OTT
• Ahmad Marwan Kaskas
• Ashley Keel, DPT
• Christina Keeler, RRT
• Jennifer Kelley, MD
• Kelly Optometry, a Professional Corporation
• Carl Aris Kelly III, O.D.
• Mallory Jane Kelly
• Nancy Lynne Kelly

• Physician Assistant in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.