Kevin John Bordelon, M.D.
Individual provider Active NPI Internal Medicine Physician · Marksville, LA
NPI 1972506491 · NPPES record last updated Jan 4, 2011
Key facts
- NPI
- 1972506491
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 023281 (LA)
- Practice address
- 4239 Highway 1192
Suite 200
Marksville, LA 71351-4771 - Phone
- (318) 253-8600
- Fax
- (318) 253-8654
- NPI assigned
- May 30, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 11
Hospital & facility affiliations 23
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Louisiana State University School of Medicine in Shreveport, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- CLHG-Avoyelles LLC
Practice addresses (Care Compare)
4239 Hwy 1192
Suite 300
Marksville, LA 71351-4772
Phone (318) 253-8611
Hospital & facility affiliations
- Allegiance Home Health of East Central Louisiana
- Lagniappe Homecare Alexandria
- Centerwell Home Health
- Avoyelles Hospital
- Bunkie General Hospital
- Christus St Frances Cabrini Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050309000307 | LA | Practitioner - Internal Medicine | 2365490653 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 023281 | LA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CLHG-Avoyelles LLC | Current |
Accepting new patients | |
| CLHG-Avoyelles LLC | Current |
Accepting new patients | |
| CLHG-Avoyelles LLC | Current | Accepting new patients | |
| Hawkeye Medical, LLC | Current |
Accepting new patients |
Locations
4239 Highway 1192
Ste 300
Marksville, LA 71351
Phone (318) 253-0677
4231 Highway 1192
Marksville, LA 71351
Phone (318) 240-6000
Interoperability endpoints
- kevin.bordelon.1@30808.direct.athenahealth.com
- kevin.bordelon.1@16696.direct.athenahealth.com
- drkevinbordelon@aacapmc-la.direct.office.nextgen.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 023281 | LA | Yes |
Addresses
Primary practice location
4239 Highway 1192
Suite 200
Marksville, LA 71351-4771
Mailing address
4239 Highway 1192
Suite 200
Marksville, LA 71351-4771
Phone (318) 253-8600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1541729 | Medicaid | LA |
Other providers in Marksville, LA
- Beyond a Spectrum Making Connections That Matter
- Bio-Medical Applications of Louisiana, LLC
- Misty Lauren Blanchard
- Bridget L Bordelon
- James Lynn Bordelon Jr.
- Kimberly Bordelon
- Madison Bordelon
- Mallory Bordelon
- Melissa Jeanne Breaux
- Donna L Breen
All providers in Marksville, LA · Internal Medicine Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.