Jacqueline Luter Calloway

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

9903 Issued in LA

Practice address

1418 Tiger Dr
Thibodaux, LA 70301-4337

Phone

(985) 449-4055

NPI assigned

Mar 6, 2018

Last updated

Jun 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Magnolia Family Services LLC

  • Community/Behavioral Health Agency
  • Thibodaux, LA
  • NPI 1508982455
  NPD (past)

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

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1053813048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SAXONY DR",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703642871",
            "telephone_number": "228-223-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 TIGER DR",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014337",
            "telephone_number": "985-449-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTER CALLOWAY",
        "first_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-06",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "LA",
            "license": "9903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOUISIANA STATE BOARD OF SOCIAL WORK",
            "identifier": "9903",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOUISIANA STATE BOARD OF PRACTICAL NURSING",
            "identifier": "780830",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Da'Quita Lucien
• Luis Lujano
• Kathy Jean Luke, CPSS
• Kenneth Michael Luminais Jr., DDS
• Alyssa Nicole Lusco, PA
• Kalie Fick Lyles, ABA
• M4Ve Physical Therapy LLC
• Sydnei Mabile
• D Rita Maduell, LCSW
• John Wesley Magee III, M.D.

• Case Manager/Care Coordinator in Thibodaux, LA
• Providers in Thibodaux, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.