KENNEDY POOLE


Address: 1643 Carter St Ste 1, Vidalia, LA 71373-3157
Phone: 3183368707

KENNEDY POOLE (NPI# 1053928622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053928622
Entity Type Individual
Full Name KENNEDY POOLE
Credential PA-C
Practice Address 1643 Carter St Ste 1
Vidalia
LA 71373-3157
Mailing Address 8832 Highway 129
Monterey
LA 71354-4551
Practice Telephone 3183368707
Enumeration Date 2020-09-28
Last Update Date 2020-09-28
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
324530 LA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1643 CARTER ST STE 1
City VIDALIA
State LA
Zip Code 71373-3157

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1710513494 Total Urgent Care Clinic/Center 4014 Carter Street, Vidalia, LA 71373 2020-03-13
1609412097 Hulin Urgent Care Services, LLC Clinic/Center 4319 Highway 84, Vidalia, LA 71373 2019-11-21
1720562556 Neashion Marie Davis Counselor 1644 B Carter Street. Suite #2, Vidalia, LA 71373 2018-09-18
1992292403 Angelica Francheska Woods Counselor 1644 B. Carter Street Suite 2, Vidalia, LA 71373 2018-04-19
1164973780 Linda Sherbia Counselor 1644 B Carter St., Suite 2, Vidalia, LA 71373 2016-10-19
1518418045 Cheryl Clark Case Manager/Care Coordinator 1644 B Carter Suite 2, Vidalia, LA 71373 2016-10-19
1972054500 Sherry Cade Counselor 1644 B Carter Street, Suite 2, Vidalia, LA 71373 2016-10-19
1457801136 Sarai Johnson Counselor 1644 B Carter Street Suite 2, Vidalia, LA 71373 2016-10-06
1053766410 Erin Fournet Woodruff Physical Therapist 402 Holly Street, Vidalia, LA 71373 2016-05-04
1184084113 Troy Nolan Thomas Jr. Counselor 4012 Carter St., Vidalia, LA 71373 2016-03-03
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1932253606 John Burton Derrick Physician Assistant 300 Arlington Dr, Vidalia, GA 30474-0645 2007-01-22
1689163685 Daniel Lauren Dasher Physician Assistant 210 Mose Coleman Dr, Vidalia, GA 30474-8677 2018-05-04
1962873711 Leah M Waller Physician Assistant 1 Meadows Pkwy, Vidalia, GA 30474-8759 2015-10-19
1063759744 Rebecca Arthur Foster Physician Assistant 1154 Logan Sewell Dr, Vidalia, LA 71373-3342 2013-01-15
1982698361 Dustin J Carter Physician Assistant 200 Maple Dr, Vidalia, GA 30474-8907 2005-08-31
1265426639 Robert Lee Arnold Physician Assistant 200 Maple Dr, Vidalia, GA 30474-8907 2005-08-31

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1174120307 Olivia Hockenjos Physician Assistant 1000 Chinaberry Dr Ste 1200, Bossier City, LA 71111-2463 2020-10-01
1699382176 Morgan Prejean Physician Assistant 11445 Coursey Blvd Ste L, Baton Rouge, LA 70816-0411 2020-09-28
1972118776 Emma W Bollich Physician Assistant 6703 Ambassador Caffery Pkwy Ste 2, Broussard, LA 70518-5283 2020-09-09
1316595937 Antonia Colombo Physician Assistant 2705 Fable St, Meraux, LA 70075-2372 2019-08-27
1861058752 Christina Daigle Physician Assistant 1057 Paul Maillard Rd Ste 2210, Luling, LA 70070-4349 2019-05-15
1376078022 Brian Ammon Physician Assistant 11831 Oakwilde Ave, Baton Rouge, LA 70810-3120 2017-05-01
1912448036 Christy Stoltz Physician Assistant 120 N Pinaud St, Saint Martinville, LA 70582-4732 2017-03-09
1790228013 Brian Keith Fontenot Physician Assistant 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 2016-11-18
1932658002 Taylor Christensen Mahtook Physician Assistant 4650 Ambassador Caffery Pkwy Ste 101, Lafayette, LA 70508-6926 2016-09-29
1558819532 Heather Roan Physician Assistant 2449 Hospital Dr Ste 400, Bossier City, LA 71111-1914 2016-09-19
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Competitor

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City VIDALIA
Zip Code 71373

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Dataset Information

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.

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