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

Mr. Roderick Kelly, PA

Individual provider Physician Assistant · NPI 1275637472

Mr. Roderick Kelly, PA is a Physician Assistant in Fort Polk, Louisiana. Qualified in 2000, 26 years ago. Practices with Ward 3 4 and 10 Hospital Service District of Parish of Union, a 14-clinician group and works from 4 locations. Licensed in Louisiana and Texas.

Years since qualifying
26
Licensed in
LA, TX
In the registry since
2006
Specialties on file
2
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

1585 3rd St
Fort Polk, LA 71459-5102
Phone: (337) 531-3011
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 1549 E 70th St Ste 300, Shreveport, LA 71105-5056 — (318) 300-3898
  • 1509 W Loop 281, Longview, TX 75604-2820 — (903) 759-9355
  • 800 E Dawson St, Tyler, TX 75701-2036 — (903) 606-4262

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA02232 (TX)
Physician Assistant Taxonomy 363A00000X · Licence PA200615 (LA)

Record details

NPI number1275637472
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 11, 2006
Last updated in NPPESSeptember 16, 2025
Certification dateSeptember 16, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Ward 3 4 And 10 Hospital Service District Of Parish Of Union — 14 clinicians
Accepts Medicare assignment Not indicated
Practice locations7 on file with Medicare

Other providers in Fort Polk