Individual provider Active NPI

Jessica Ann Borne, MD

  • Diagnostic Radiology Physician
  • Houma, LA
National Provider Identifier
1073535852
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
018747 Issued in LA
Practice address
1990 Industrial Blvd
Houma, LA 70363-7055
Phone
(985) 868-9300
Fax
(985) 851-0053
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 018747 LA
Diagnostic Radiology Physician 2085R0202X 018747 LA Primary

Addresses

Primary practice location

1990 Industrial Blvd
Houma, LA 70363-7055

Mailing address

1990 Industrial Blvd
Houma, LA 70363-7055
Phone (985) 868-9300

Other identifiers 1

IdentifierTypeStateIssuer
1660680MedicaidLA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060307000505 LA Practitioner - Diagnostic Radiology 2961419585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Tulane University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Louisiana Medical AssociatesGroup PAC ID 8527968650, 112 clinicians

Practice addresses (Care Compare)

1990 Industrial Blvd
Houma, LA 70363-7055
Phone (985) 868-9300

Hospital & facility affiliations

  • Leonard J Chabert Medical Center Hospital, Houma, LA, CCN 190183
  • Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
018747LAMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Louisiana Medical Associates CurrentSince Jan 3, 2007 Accepting new patients
South Louisiana Medical Associates Diagnostic Radiology Current Accepting new patients
South Louisiana Medical Associates CurrentSince Jan 3, 2007 Accepting new patients
Jab Rad, LLC Diagnostic Radiology PastSince Dec 1, 2006 Accepting new patients
Imaging Specialists of New Orleans Diagnostic Radiology Past Accepting new patients
Southern Brain and Spine Past Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G Past Accepting new patients
Lsu Medical Center Past Accepting new patients
Administrators of the Tulane Educational Fund Past Accepting new patients

Locations

1990 Industrial Blvd
Houma, LA 70363
Phone (985) 868-9300

605 Enterprise Dr
Ste B
Houma, LA 70360
Phone (985) 262-1639

1978 Industrial Blvd
Houma, LA 70363
Phone (985) 873-1814

Organizations & group practices 9

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 2

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407974400000",
    "number": "1073535852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 INDUSTRIAL BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703637055",
            "telephone_number": "985-868-9300",
            "fax_number": "985-851-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 INDUSTRIAL BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703637055",
            "telephone_number": "985-868-9300",
            "fax_number": "985-851-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORNE",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2014-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "LA",
            "license": "018747",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "018747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1660680",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

Verify at the official NPI Registry.