Individual provider Active NPI

Jennifer R McCann

  • Obstetrics & Gynecology Physician
  • Deridder, LA
National Provider Identifier
1083816854
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
201272 Issued in LA
Practice address
401 S Washington St
Deridder, LA 70634-4863
Phone
(337) 515-4537
Fax
(337) 460-1348
NPI assigned
Jun 4, 2007
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 201272 LA Primary
Obstetrics Physician 207VX0000X 201272 LA

Addresses

Primary practice location

401 S Washington St
Deridder, LA 70634-4863

Mailing address

401 S Washington St
Deridder, LA 70634-4863
Phone (337) 515-4537

Other practice location 1

206 W 5th St
Deridder, LA 70634-4856
Phone (337) 463-5582

Other identifiers 2

IdentifierTypeStateIssuer
201988701MedicaidTX
1093271MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL McCann.wellness1@gmail.com Direct

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
I20090709000624 LA Practitioner - Obstetrics/Gynecology 5294887972 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Louisiana State University School of Medicine in Shreveport, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

401 S Washington St
Deridder, LA 70634-4863
Phone (337) 515-4537

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201272LAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CLHG-Avoyelles LLC CurrentSince May 1, 2023 Accepting new patients
West Louisiana Health Services Inc Obstetrics & Gynecology CurrentSince Oct 21, 2020 Accepting new patients
CLHG-Leesville CurrentSince Nov 8, 2021 Accepting new patients
Jennifer Rudd McCann MD, LLC Obstetrics & Gynecology CurrentSince Sep 14, 2021 Accepting new patients
Minden Physician Practices LLC Current Accepting new patients
Obhg Louisiana, LLC Obstetrics & Gynecology CurrentSince Jun 1, 2024 Accepting new patients
CLHG-Avoyelles LLC CurrentSince May 1, 2023 Accepting new patients
Minden Physician Practices LLC CurrentSince Mar 13, 2023 Accepting new patients
Minden Physician Practices LLC Obstetrics & Gynecology CurrentSince Mar 13, 2023 Accepting new patients
Beauregard Women's Health Center, LLC Obstetrics & Gynecology CurrentSince Sep 27, 2011 Accepting new patients
CLHG-Leesville Current Accepting new patients
Hawkeye Medical, LLC CurrentSince Sep 19, 2024 Accepting new patients

Locations

8585 Picardy Ave
Baton Rouge, LA 70809
Phone (225) 763-4000

206 W 5th St
Deridder, LA 70634
Phone (337) 462-7106

401 S Washington St
Deridder, LA 70634
Phone (337) 515-4537

600 S Pine St
Deridder, LA 70634
Phone (337) 462-7100

2906 Main St
Hessmer, LA 71341
Phone (318) 315-7093

1214 Coolidge Blvd
Lafayette, LA 70503
Phone (337) 234-9191

1610 Water St
Lecompte, LA 71346
Phone (318) 406-8010

1020 W Fertitta Blvd
Leesville, LA 71446
Phone (337) 239-5278

110 La Rue Medecine St
Marksville, LA 71351
Phone (318) 253-6564

4231 Highway 1192
Marksville, LA 71351
Phone (318) 240-6000

4239 Highway 1192
Ste 300
Marksville, LA 71351
Phone (318) 253-0677

5541 Highway 1
Marksville, LA 71351
Phone (318) 240-7240

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

1 Medical Plaza Pl
Minden, LA 71055
Phone (318) 371-4042

1111 Homer Rd
Minden, LA 71055
Phone (318) 377-7500

427 Homer Rd
Minden, LA 71055
Phone (318) 377-8855

431 Homer Rd
Minden, LA 71055
Phone (318) 377-8855

Networks

  • LA PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: jennifer.mccann.1@3681.direct.athenahealth.com

Organizations & group practices 12

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.

Hospital & facility affiliations 1

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": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1083816854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S WASHINGTON ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344863",
            "telephone_number": "337-515-4537",
            "fax_number": "337-460-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S WASHINGTON ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344863",
            "telephone_number": "337-515-4537",
            "fax_number": "337-460-1348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "206 W 5th St",
            "address_purpose": "LOCATION",
            "city": "Deridder",
            "state": "LA",
            "postal_code": "706344856",
            "country_code": "US",
            "telephone_number": "337-463-5582",
            "fax_number": "337-460-1348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCANN",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "LA",
            "license": "201272",
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "LA",
            "license": "201272",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201988701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093271",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "McCann.wellness1@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "401 S Washington St",
            "city": "Deridder",
            "state": "LA",
            "country_code": "US",
            "postal_code": "706344863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Deridder, LA

Sources for this page

Verify at the official NPI Registry.