NPIMap

Individual provider Active NPI

Kerry Elizabeth Mahan, MD

  • Hospitalist Physician
  • Hot Springs, AR
National Provider Identifier
1871556589
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
E-2055 Issued in AR
Practice address
1 Mercy LN
Suite 201
Hot Springs, AR 71913-6442
Phone
(501) 609-2222
Fax
(501) 321-9689
NPI assigned
Apr 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M0476 TX
Hospitalist Physician 208M00000X E-2055 AR Primary

Addresses

Primary practice location

1 Mercy LN
Suite 201
Hot Springs, AR 71913-6442

Mailing address

PO Box 21850
Hot Springs, AR 71903-1850
Phone (501) 609-2222

Other identifiers 6

IdentifierTypeStateIssuer
170823201MedicaidTX
137704001MedicaidAR
170823204MedicaidTX
170823205MedicaidTX
170823206MedicaidTX
170823203MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240515003115 LA Practitioner - Internal Medicine 3274582085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Louisiana Physicians LLC 44 clinicians

Practice addresses (Care Compare)

1453 E Bert Kouns Industrial Loop
Christus Highland Medical Center
Shreveport, LA 71105-5634
Phone (318) 681-4500

Hospital & facility affiliations

  • Christus Shreveport-Bossier Health System Hospital, Shreveport, LA, CCN 190041
  • Natchitoches Regional Medical Center Hospital, Natchitoches, LA, CCN 190007
  • Christus Coushatta Health Care Center Hospital, Coushatta, LA, CCN 191312
  • Sabine Medical Center Hospital, Many, LA, CCN 190218
  • Minden Medical Center Hospital, Minden, LA, CCN 190144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M0476TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Louisiana Physicians, LLC Internal Medicine CurrentSince Apr 8, 2024 Accepting new patients
Christus Health Northern Louisiana Past Accepting new patients
Sparks Medical Foundation Internal Medicine Past Accepting new patients

Locations

2531 Viking Dr
Bossier City, LA 71111
Phone (318) 681-7000

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

Organizations & group practices 3

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.

Hospital & facility affiliations 11

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1871556589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21850",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719031850",
            "telephone_number": "501-609-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MERCY LN",
            "address_2": "SUITE 201",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136442",
            "telephone_number": "501-609-2222",
            "fax_number": "501-321-9689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "KERRY",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M0476",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AR",
            "license": "E-2055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170823201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137704001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170823204",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170823205",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170823206",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170823203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs, AR

Sources for this page

Verify at the official NPI Registry.