Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly Christine Boal, PA

Individual provider Physician Assistant · NPI 1215223763

Kelly Christine Boal, PA is a Physician Assistant in Baton Rouge, Louisiana. Qualified in 2011, 15 years ago. Practices with Our Lady of the Lake Physician Group LLC, a 635-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
15
Licensed in
LA
In the registry since
2011
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

5439 Airline Hwy
Baton Rouge, LA 70805-1712
Phone: (225) 358-4853
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7777 Hennessy Blvd, Baton Rouge, LA 70808-4300 — (225) 765-7163

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 200456 (LA)

Record details

NPI number1215223763
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 23, 2011
Last updated in NPPESFebruary 27, 2026
Certification dateFebruary 27, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Our Lady Of The Lake Physician Group Llc — 635 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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