KYLE FITZGERALD (NPI# 1568893907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568893907 |
| Entity Type | Individual |
| Full Name | KYLE FITZGERALD |
| Credential | P. A |
| Practice Address |
10512 S Glenstone Pl Suite 102 Baton Rouge LA 70810-2966 |
| Practice Telephone | 2257576555 |
| Practice Fax Number | 2257576179 |
| Mailing Telephone | 2257576555 |
| Mailing Fax Number | 2257576179 |
| Enumeration Date | 2013-12-11 |
| Last Update Date | 2015-08-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA.200457 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2355007 | 05 | |
| LA | MEDICARE PTAN | 334144YNB7 | 01 |
| Street Address |
10512 S GLENSTONE PL SUITE 102 |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70810-2966 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922093210 | Justin Grady Matrisciano | Internal Medicine | 10512 S Glenstone Pl, Suite 102, Baton Rouge, LA 70810-2966 | 2005-09-13 |
| 1548668452 | Grady Endocrinology Center LLC | Internal Medicine | 10512 S Glenstone Pl, Suite 102, Baton Rouge, LA 70810-2966 | 2014-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639734973 | Baton Rouge Clinic, A Medical Corporation | Podiatrist | 8160 Ymca Blvd, Suite C, Baton Rouge, LA 70810 | 2019-05-02 |
| 1699278135 | Taylor Denise Debourg | Specialist/Technologist | 8921 Boone Drive, Baton Rouge, LA 70810 | 2018-03-12 |
| 1528583945 | Baton Rouge Perio, L.L.C. | Dentist | 10723 N. Oak Hills Parkway, Bldg. B, Baton Rouge, LA 70810 | 2017-08-07 |
| 1902334931 | Reginald Shaffer | Counselor | 13621 Kenner Ave Apt C, Baton Rouge, LA 70810 | 2017-06-03 |
| 1770010381 | Keona Julien | Case Manager/Care Coordinator | 9270 Siegen Ln Suite 101, Baton Rouge, LA 70810 | 2017-05-12 |
| 1205372893 | Grand Canyon Mobile Dentistry | Dentist | 8480 Bluebonnet Blvd Ste E, Baton Rouge, LA 70810 | 2017-01-06 |
| 1215395173 | Kimberly Booker | Counselor | 9371 Bimini Dr, Baton Rouge, LA 70810 | 2016-02-08 |
| 1710354022 | St Gabriel Health Clinic, Inc | Clinic/Center | 9211 Parkway Dr, Baton Rouge, LA 70810 | 2015-08-24 |
| 1942682430 | Jasmine Alexander | Counselor | 9270 Siegen Ln Bldg 101, Baton Rouge, LA 70810 | 2015-06-22 |
| 1073991535 | James Michael Robinson | Family Medicine | 12525 Perkins Rd Ste A, Baton Rouge, LA 70810 | 2015-05-15 |
| Find all providers in zip 70810 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508474958 | Katherine Whittington | Physician Assistant | 778 Albert Hart Dr, Baton Rouge, LA 70808-5805 | 2020-07-21 |
| 1881213254 | Sana Badat | Physician Assistant | 18406 Cedar Line Dr, Baton Rouge, LA 70817-4263 | 2020-04-15 |
| 1770116022 | Auxilio Surgical Solutions Ras, LLC | Physician Assistant | 140 Valhalla Blvd, Baton Rouge, LA 70810-3649 | 2020-02-14 |
| 1861025116 | Auxilio Surgical Solutions Crb, LLC | Physician Assistant | 2621 Cedar Lodge Dr, Baton Rouge, LA 70809-1058 | 2020-02-14 |
| 1154988186 | Michael Chafin Dugas | Physician Assistant | 17000 Medical Center Dr # 70816, Baton Rouge, LA 70816-3246 | 2019-05-24 |
| 1700399037 | Louisana Em-i Medical Services A Medical Corporation | Physician Assistant | 501 Louisiana Ave, Baton Rouge, LA 70802-5921 | 2017-11-08 |
| 1376052514 | Shanna Evans | Physician Assistant | 18303 Perkins Rd E Ste 304, Baton Rouge, LA 70810-3939 | 2017-09-20 |
| 1336668425 | Gregory Scott Miller | Physician Assistant | 8751 Sullivan Rd, Baton Rouge, LA 70818-6014 | 2017-09-11 |
| 1982121141 | Matthew Stephen Chappellie | Physician Assistant | 8585 Picardy Ave Ste 518, Baton Rouge, LA 70809-3748 | 2017-08-28 |
| 1245751569 | Megan Stabiler Schmitt | Physician Assistant | 12525 Perkins Rd Ste B, Baton Rouge, LA 70810-1907 | 2017-06-28 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70810 |
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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.