Individual provider Active NPI

Jodie Diane Harrison, AGNP-C

  • Gerontology Nurse Practitioner
  • Slidell, LA
National Provider Identifier
1063061950
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AG09190008 Issued in LA
Practice address
1120 Robert Blvd Ste 360
Slidell, LA 70458-2069
Phone
(985) 646-2411
Fax
(985) 646-2413
NPI assigned
Sep 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AG09190008 LA Primary

Addresses

Primary practice location

1120 Robert Blvd Ste 360
Slidell, LA 70458-2069

Mailing address

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-4000

Other names 1

  • Jodie Diane Cates Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191126000623 LA Practitioner - Nurse Practitioner 0749613198 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3000

Hospital & facility affiliations

  • Slidell Memorial Hospital Hospital, Slidell, LA, CCN 190040
  • Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036
  • Ochsner Medical Center-Hancock Hospital, Bay Saint Louis, MS, CCN 250162
  • Highland Community Hospital Hospital, Picayune, MS, CCN 250117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AG09190008LAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Mar 18, 2024 Accepting new patients
Ochsner Clinic LLC CurrentSince Mar 18, 2024 Accepting new patients
Slidell Memorial Hospital CurrentSince Sep 23, 2019 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Slidell Memorial Hospital Past Accepting new patients

Locations

1514 Jefferson Hwy
New Orleans, LA 70121

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

1120 Robert Blvd
Ste 390
Slidell, LA 70458
Phone (985) 280-6645

1120 Robert Blvd
Ste 200
Slidell, LA 70458
Phone (985) 646-2223

Organizations & group practices 5

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1063061950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 ROBERT BLVD STE 360",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582069",
            "telephone_number": "985-646-2411",
            "fax_number": "985-646-2413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "JODIE",
        "middle_name": "DIANE",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "LA",
            "license": "AG09190008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODIE",
            "last_name": "CATES",
            "middle_name": "DIANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.