Individual provider Active NPI

Kelby Friday

  • Registered Nurse
  • Pineville, LA
National Provider Identifier
1962049320
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN158940 Issued in LA
Practice address
2495 Shreveport Hwy
Pineville, LA 71360-4044
Phone
(318) 623-9335
NPI assigned
Dec 4, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN158940 LA Primary

Addresses

Primary practice location

2495 Shreveport Hwy
Pineville, LA 71360-4044

Mailing address

638 Bay City Rd
Elizabeth, LA 70638-4009
Phone (318) 623-9335

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

LicenseStateTypeSpecialty
RN158940LAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1962049320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 BAY CITY RD",
            "city": "ELIZABETH",
            "state": "LA",
            "postal_code": "706384009",
            "telephone_number": "318-623-9335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 SHREVEPORT HWY",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604044",
            "telephone_number": "318-623-9335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIDAY",
        "first_name": "KELBY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-04",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN158940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pineville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.