Active NPI
Kevin Paul Landry, CST/CSFA
- Surgical Assistant
- Maurice, LA
National Provider Identifier
1811279128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 91262
- Practice address
- 301 Village Park Dr
Maurice, LA 70555-4441 - Phone
- (337) 517-8738
- NPI assigned
- Sep 13, 2011
- Last updated
- Sep 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 91262 | LA | Primary |
Addresses
Primary practice location
301 Village Park Dr
Maurice, LA 70555-4441
Mailing address
301 Village Park Dr
Maurice, LA 70555-4441
Phone (337) 517-8738
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 91262 | LA | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315872000000",
"number": "1811279128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 VILLAGE PARK DR",
"city": "MAURICE",
"state": "LA",
"postal_code": "705554441",
"telephone_number": "337-517-8738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 VILLAGE PARK DR",
"city": "MAURICE",
"state": "LA",
"postal_code": "705554441",
"telephone_number": "337-517-8738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDRY",
"first_name": "KEVIN",
"middle_name": "PAUL",
"credential": "CST/CSFA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-13",
"last_updated": "2011-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "LA",
"license": "91262",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maurice, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.