Kisatchie Medical LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

KISATCHIE MEDICAL LLC

Practice address

3425 North Blvd Ste a
Alexandria, LA 71301-3608

Phone

(318) 473-1921

Fax

(318) 473-1922

NPI assigned

Nov 19, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Wendy Christina Godeaux

Title

Office Manager

Phone

(318) 473-1921

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290124800000",
    "number": "1831491141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 NORTH BLVD STE A",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013608",
            "telephone_number": "318-473-1921",
            "fax_number": "318-473-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 NORTH BLVD STE A",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013608",
            "telephone_number": "318-473-1921",
            "fax_number": "318-473-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KISATCHIE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-19",
        "last_updated": "2010-11-19",
        "status": "A",
        "authorized_official_last_name": "GODEAUX",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "CHRISTINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "318-473-1921",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Crystal D Knight, M.S SLP
• Shannon Margaret Knight, FNP-C
• Angela Knobloch

• All providers in Alexandria, LA
• General Practice Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.