Individual provider Active NPI

Jasmine Deon McCallon

  • Personal Care Attendant
  • Metairie, LA
National Provider Identifier
1043959570
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
00000 Issued in LA
Practice address
3100 Ridgelake Dr Ste 309
Metairie, LA 70002-4938
Phone
(504) 309-0259
Fax
(504) 309-2702
NPI assigned
Jun 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care AttendantGroup: 193400000X SINGLE SPECIALTY GROUP 3747P1801X 00000 LA Primary

Addresses

Primary practice location

3100 Ridgelake Dr Ste 309
Metairie, LA 70002-4938

Mailing address

3100 Ridgelake Dr Ste 309
Metairie, LA 70002-4938
Phone (504) 309-0259

Other identifiers 1

IdentifierTypeStateIssuer
1750754727MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL METAIRIE Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
00000LAMDPersonal Care Attendant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1043959570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 RIDGELAKE DR STE 309",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700024938",
            "telephone_number": "504-309-0259",
            "fax_number": "504-309-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 RIDGELAKE DR STE 309",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700024938",
            "telephone_number": "504-309-0259",
            "fax_number": "504-309-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALLON",
        "first_name": "JASMINE",
        "middle_name": "DEON",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": "LA",
            "license": "00000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750754727",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "METAIRIE",
            "affiliation": "N",
            "endpointDescription": "Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "METAIRIE",
            "address_1": "3100 Ridgelake Dr Ste 309",
            "city": "Metairie",
            "state": "LA",
            "country_code": "US",
            "postal_code": "700024938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.