Active NPI
Children First Kidmed
- Adult Health Nurse Practitioner
- Albany, LA
National Provider Identifier
1992888036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- AP04271
- Legal business name
- CHILDREN FIRST KIDMED
- Practice address
- 19115 Florida Blvd Ste a
Albany, LA 70711-3701 - Phone
- (225) 567-7150
- Fax
- (225) 567-7120
- NPI assigned
- Oct 23, 2006
- Organization subpart
- Yes
- Parent organization
- CHILDREN FIRST KIDMED
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Pediatric Nurse Practitioner
- Hammond, LA
- NPI 1285802785
Change of ownership 1
Medicare changes of ownership in which this facility was the buyer or the seller.
-
- Rural Health Clinic/Center
- Hammond, LA
- NPI 1366946030
Sold to, 2017-10-01
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Change-of-ownership history 1
Medicare enrollment files| Date | Event | Counterparty |
|---|---|---|
| Oct 1, 2017 | Change of Ownership | Children'S International Medical Group |
National Provider Directory
National Provider Directory- Part of
- Children First Kidmed
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nicole A Bailey, APRN
- Title
- Adult Nurse Practitioner/Manager
- Phone
- (225) 567-7150
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | AP04271 | LA | Primary |
Addresses
Primary practice location
19115 Florida Blvd Ste a
Albany, LA 70711-3701
Mailing address
19115 Florida Blvd
Ste. a
Albany, LA 70711
Phone (225) 567-7150
Other names 1
- Albany Health Care Clinic
NPI Registry JSON
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1225411200000",
"number": "1992888036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19115 FLORIDA BLVD",
"address_2": "STE. A",
"city": "ALBANY",
"state": "LA",
"postal_code": "70711",
"telephone_number": "225-567-7150",
"fax_number": "225-567-7120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19115 FLORIDA BLVD STE A",
"city": "ALBANY",
"state": "LA",
"postal_code": "707113701",
"telephone_number": "225-567-7150",
"fax_number": "225-567-7120"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHILDREN FIRST KIDMED",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CHILDREN FIRST KIDMED",
"enumeration_date": "2006-10-23",
"last_updated": "2008-10-31",
"status": "A",
"authorized_official_last_name": "BAILEY",
"authorized_official_first_name": "NICOLE",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "ADULT NURSE PRACTITIONER/MANAGER",
"authorized_official_telephone_number": "225-567-7150",
"authorized_official_credential": "APRN"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Adult Health",
"state": "LA",
"license": "AP04271",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Albany Health Care Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Albany, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.