NPIMap

Organization Active NPI

Jackson Casemanagementand Support Coordination Services

  • Case Management Agency
  • Patterson, LA
National Provider Identifier
1083941777
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
CM27006 Issued in LA
Legal business name
JACKSON CASEMANAGEMENTAND SUPPORT COORDINATION SERVICES
Practice address
190 Highway 90
PO 1349
Patterson, LA 70392-4246
Phone
(985) 399-3236
NPI assigned
Nov 17, 2009
Last updated
Nov 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Authorized official

Name
Mrs. Tempest Jackson
Title
Owner
Phone
(985) 399-3263

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X CM27006 LA Primary

Addresses

Primary practice location

190 Highway 90
PO 1349
Patterson, LA 70392-4246

Mailing address

190 Highway 90
PO Box 1349
Patterson, LA 70392-4246
Phone (985) 399-3263

Other identifiers 1

IdentifierTypeStateIssuer
1348945MedicaidLA

National Provider Directory

National Provider Directory

Locations

190 Highway 90
Patterson, LA 70392
Phone (985) 399-3236

NPI Registry JSON

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258416000000",
    "number": "1083941777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 HIGHWAY 90",
            "address_2": "PO BOX 1349",
            "city": "PATTERSON",
            "state": "LA",
            "postal_code": "703924246",
            "telephone_number": "985-399-3263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 HIGHWAY 90",
            "address_2": "PO 1349",
            "city": "PATTERSON",
            "state": "LA",
            "postal_code": "703924246",
            "telephone_number": "985-399-3236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON CASEMANAGEMENTAND SUPPORT COORDINATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-17",
        "last_updated": "2009-11-17",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "TEMPEST",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-399-3263",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "LA",
            "license": "CM27006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1348945",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Patterson, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; 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.