Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kallie E Landry, PA-C

Individual provider Physician Assistant · NPI 1114530722

Kallie E Landry, PA-C is a Physician Assistant in Thibodaux, Louisiana. Qualified in 2020, 6 years ago. Practices with Coolidge Physician Services LLC, a 51-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
6
Licensed in
LA
In the registry since
2020
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

726 N Acadia Rd Ste 2100
Thibodaux, LA 70301-5078
Phone: (985) 447-2645
Fax: (985) 447-2604
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 324145 (LA)

Record details

NPI number1114530722
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 25, 2020
Last updated in NPPESMarch 4, 2026
Certification dateMarch 4, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Coolidge Physician Services Llc — 51 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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