DR. KELLY LANIER PAULK (NPI# 1083034557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083034557 |
| Entity Type | Individual |
| Full Name | DR. KELLY LANIER PAULK |
| Credential | M.D. |
| Practice Address |
200 W Esplanade Ave Kenner LA 70065-2489 |
| Mailing Address |
1514 Jefferson Hwy New Orleans LA 70121-2429 |
| Practice Telephone | 5044439500 |
| Mailing Telephone | 5048424000 |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2019-08-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
308434 | LA | Allopathic & Osteopathic Physicians |
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
308434 | LA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629087457 | Kelly M Paulk | Counselor | 2003 Patterson Dr, Victoria, TX 77901-5645 | 2006-08-08 |
| Street Address |
200 W ESPLANADE AVE |
| City | KENNER |
| State | LA |
| Zip Code | 70065-2489 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619971074 | Karl Neal Hanson | Family Medicine | 200 W Esplanade Ave, Ste 307, Kenner, LA 70065-2474 | 2005-06-13 |
| 1457952400 | Brittany Ragas | Nurse Practitioner | 200 W Esplanade Ave, Kenner, LA 70065-2489 | 2020-11-05 |
| 1285285510 | Louisiana State University School of Medicine In New Orleans Faculty | Specialist | 200 W Esplanade Ave, Kenner, LA 70065-2489 | 2019-09-27 |
| 1235784505 | Katherine Boston | Nurse Practitioner | 200 W Esplanade Ave, Kenner, LA 70065-2489 | 2019-08-05 |
| 1386153591 | Kayleigh Eppling Binet | Orthopaedic Surgery | 200 W Esplanade Ave, Kenner, LA 70065-2489 | 2017-09-20 |
| 1609317999 | Stephen Lambert | Family Medicine | 200 W Esplanade Ave, Kenner, LA 70065-2489 | 2017-03-20 |
| 1467908764 | Rekha Ramachandran | Internal Medicine | 200 W Esplanade Ave, Suite 210, Kenner, LA 70065-2489 | 2016-08-28 |
| 1700230745 | Penny Ann Boyle | Family Medicine | 200 W Esplanade Ave, Suite 412, Kenner, LA 70065-2489 | 2016-04-15 |
| 1205217684 | Emily Elizabeth Montz | Physician Assistant | 200 W Esplanade Ave, Ste 210, Kenner, LA 70065-2489 | 2015-06-11 |
| 1215347570 | Adeel Zia | Family Medicine | 200 W Esplanade Ave, Suite 409, Kenner, LA 70065-2489 | 2014-05-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689226946 | Silver Lining Dentistry & Co. | Clinic/Center | 2305 West Esplanade Suit U, Kenner, LA 70065 | 2019-07-16 |
| 1912462615 | Tamiqua Monique Torres | Lactation Consultant, Non-RN | 4129 Idaho Ave #a, Kenner, LA 70065 | 2019-02-06 |
| 1649766650 | Kenner Dental Associates, LLC | Dentist | 1501 32nd St., Kenner, LA 70065 | 2018-07-03 |
| 1194216465 | Shanne Gilbert | Technician, Pathology | Kenner Metairie and Surrounding Areas, Kenner, LA 70065 | 2018-05-23 |
| 1437668597 | Jbl Rx LLC | Pharmacy | 2305 West Esplanade Ave, Suite T, Kenner, LA 70065 | 2017-09-21 |
| 1073049532 | Jonathan English | Counselor | 3701 Tulane Dr, Kenner, LA 70065 | 2017-05-03 |
| 1033644752 | Fonteno Services LLC | Non-emergency Medical Transport (VAN) | 3017 Huntsville, St, Kenner, LA 70065 | 2017-05-01 |
| 1821521915 | Shondreca Nicole Sanders | Counselor | 4520 Williams Blvd, #y383, Kenner, LA 70065 | 2017-04-06 |
| 1225570104 | Dominiece Lacroix | Nurse Practitioner | 3616 Loyola Drive, 271, Kenner, LA 70065 | 2016-11-09 |
| 1427506286 | Lisandra Nunez | Counselor | 153 Auburn Pl, Kenner, LA 70065 | 2016-09-21 |
| Find all providers in zip 70065 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003120080 | Spine Intervention, LLC | Physical Medicine & Rehabilitation | 1919 Veterans Memorial Blvd, Suite 101, Kenner, LA 70062-4003 | 2010-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033736343 | David S Vaughan | Physical Medicine & Rehabilitation | 3926 Barron St Ste C210, Metairie, LA 70002-5798 | 2020-07-02 |
| 1184196784 | Evan Phillips | Physical Medicine & Rehabilitation | 1103 Kaliste Saloom Rd Ste 100&102, Lafayette, LA 70508-5783 | 2018-12-19 |
| 1093236283 | Spine Management Group, LLC | Physical Medicine & Rehabilitation | 4600 S Claiborne Ave Ste 100, New Orleans, LA 70125-5010 | 2017-06-28 |
| 1467808519 | Healthspere Management Group | Physical Medicine & Rehabilitation | 872 Behrman Hwy, Gretna, LA 70056-4546 | 2016-05-09 |
| 1144568320 | Rees Medical Services, LLC | Physical Medicine & Rehabilitation | 1211 Coolidge Blvd Ste 401, Lafayette, LA 70503-2638 | 2013-01-23 |
| 1962636597 | Bayou Physical Medicine, Inc. | Physical Medicine & Rehabilitation | 12038 Lake Sherwood Ave N, Baton Rouge, LA 70816-4341 | 2009-05-11 |
| 1386807444 | Axcess Medical Clinic, Inc | Physical Medicine & Rehabilitation | 524 Elmwood Park Blvd, Suite 100, Harahan, LA 70123-3339 | 2008-07-08 |
| 1124298344 | Satvik Bhargav Munshi | Physical Medicine & Rehabilitation | 3820 Lapalco Blvd, Harvey, LA 70058 | 2008-03-04 |
| 1417167750 | Markus Vattakattil John | Physical Medicine & Rehabilitation | 4021 We Heck Ct, Building M-1, Baton Rouge, LA 70816-0416 | 2007-05-23 |
| 1437263522 | Omni Pain Management, LLC | Physical Medicine & Rehabilitation | 2701 David Dr, Suite A, Metairie, LA 70003-4511 | 2006-08-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.