Individual provider Active NPI

Kelli Coleman, MD

  • Ophthalmology Physician
  • Shreveport, LA
National Provider Identifier
1952864175
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
323653 Issued in LA
Practice address
2611 Greenwood Rd
Shreveport, LA 71103-3907
Phone
(318) 212-2020
Fax
(318) 212-6336
NPI assigned
Apr 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME161177 FL
Ophthalmology Physician 207W00000X 323653 LA Primary

Addresses

Primary practice location

2611 Greenwood Rd
Shreveport, LA 71103-3907

Mailing address

2611 Greenwood Rd
Shreveport, LA 71103-3907
Phone (318) 212-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230620002447 FL Practitioner - Ophthalmology 3274991443
I20241206002138 LA Practitioner - Ophthalmology 3274991443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Louisiana State University School of Medicine in Shreveport, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WK Pierremont Eye InstituteGroup PAC ID 3375563216, 12 clinicians

Practice addresses (Care Compare)

2611 Greenwood Rd
Shreveport, LA 71103-3907
Phone (318) 212-2020

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
323653LAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WK Pierremont Eye Institute Ophthalmology CurrentSince Nov 28, 2024 Accepting new patients

Locations

2611 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-2020

1202 Louisiana Ave
Shreveport, LA 71101
Phone (318) 212-8946

Organizations & group practices 1

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 4

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": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1952864175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 GREENWOOD RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033907",
            "telephone_number": "318-212-2020",
            "fax_number": "318-212-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 GREENWOOD RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033907",
            "telephone_number": "318-212-2020",
            "fax_number": "318-212-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "KELLI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-14",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME161177",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "323653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.