Jackson Street Medical Center

Primary specialty

Non-Surgical Family Planning Clinic/CenterTaxonomy code 261QF0050X

License

12742R Issued in LA

Legal business name

JACKSON STREET MEDICAL CENTER

Practice address

5623 Jackson Street Ext
Alexandria, LA 71303-2326

Phone

(318) 455-0129

Fax

(318) 443-3284

NPI assigned

Nov 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jose G Zavaleta, MD

Title

Physician

Phone

(318) 445-0129

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195776000000",
    "number": "1053592600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5623 JACKSON STREET EXT",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032326",
            "telephone_number": "318-455-0129",
            "fax_number": "318-443-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5623 JACKSON STREET EXT",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032326",
            "telephone_number": "318-455-0129",
            "fax_number": "318-443-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON STREET MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-23",
        "last_updated": "2007-11-23",
        "status": "A",
        "authorized_official_last_name": "ZAVALETA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "318-445-0129",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": "LA",
            "license": "12742R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Calvin Luke Ivie, CRNA
• Joshua Ivory
• Molly McKay Ivy
• J a Badeaux III MD a Professional Medical Corporation
• Jackson Group Home
• Jackson Street Pediatrics, LLC
• Ashley Jackson, LPN
• Brittney Baylor Jackson, CNA
• Falon Jackson
• Jamerson E. Jackson

• Non-Surgical Family Planning Clinic/Center in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Non-Surgical Family Planning Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2007; 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.