Individual provider Active NPI

Katie Queen, M.D.

  • Pediatrics Physician
  • Bogalusa, LA
National Provider Identifier
1952545972
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD.203961 Issued in LA
Practice address
433 Plaza St Ste 1a
Bogalusa, LA 70427-3729
Phone
(225) 730-6970
Fax
(985) 730-6398
NPI assigned
Apr 21, 2009
Last updated
Oct 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P2419 TX
Pediatrics Physician 208000000X MD.203961 LA Primary

Addresses

Primary practice location

433 Plaza St Ste 1a
Bogalusa, LA 70427-3729

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 765-0011

Other practice location 1

8200 Constantin Blvd Fl 4
Baton Rouge, LA 70809-3481
Phone (225) 765-5500

Other practice location 2

95 Judge Tanner Blvd
Department of Pediatrics
Covington, LA 70433-7500
Phone (985) 867-3800

Other identifiers 1

IdentifierTypeStateIssuer
1883042MedicaidLA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170329001328 LA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 6507014214 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC Pediatrics CurrentSince Oct 1, 2021 Accepting new patients
Children's Hospital Pediatrics CurrentSince Mar 11, 2017 Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince Oct 1, 2021 Accepting new patients
Wash-St Tammany Reg Medical Center Current Accepting new patients
Children's Hospital CurrentSince Mar 11, 2017 Accepting new patients
Our Lady of the Angels Hospital, Inc. Past Accepting new patients
TCH Pediatric Associates, Inc Pediatrics Past Accepting new patients
Washington St. Tammany Regional Medical Center PastSince Oct 10, 2021 Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

6400 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 330-0497

8200 Constantin Blvd
Baton Rouge, LA 70809
Phone (225) 374-1610

8200 Constantin Blvd
Fl 3
Baton Rouge, LA 70809
Phone (225) 765-1982

8200 Constantin Blvd
Fl 4
Baton Rouge, LA 70809

433 Plaza St
Bogalusa, LA 70427
Phone (985) 730-6700

433 Plaza St
Ste 1A
Bogalusa, LA 70427
Phone (985) 730-6970

141 Ormond Center Ct
Destrehan, LA 70047
Phone (985) 764-7337

3040 33rd St
Metairie, LA 70001
Phone (504) 219-0880

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1952545972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-765-0011",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 PLAZA ST STE 1A",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704273729",
            "telephone_number": "225-730-6970",
            "fax_number": "985-730-6398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8200 Constantin Blvd Fl 4",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708093481",
            "country_code": "US",
            "telephone_number": "225-765-5500",
            "fax_number": "225-374-1678",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "95 Judge Tanner Blvd",
            "address_2": "Department of Pediatrics",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "LA",
            "postal_code": "704337500",
            "country_code": "US",
            "telephone_number": "985-867-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUEEN",
        "first_name": "KATIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-21",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P2419",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD.203961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1883042",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bogalusa, LA

Sources for this page

Verify at the official NPI Registry.