Individual provider Active NPI

Adiaha Njeri Mboup Brown, NP

  • Family Nurse Practitioner
  • Gretna, LA
National Provider Identifier
1083993836
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN123033-AP06528 Issued in LA
Practice address
2500 Belle Chasse Hwy
Gretna, LA 70056
Phone
(504) 391-5454
NPI assigned
Aug 10, 2011
Last updated
Feb 25, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN123033-AP06528 LA Primary

Addresses

Primary practice location

2500 Belle Chasse Hwy
Gretna, LA 70056

Mailing address

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-9119

Other identifiers 2

IdentifierTypeStateIssuer
02050390MedicaidMS
2169734MedicaidLA

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
I20111107000430 LA Practitioner - Nurse Practitioner 0749453850 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foucher Emergency Group LLCGroup PAC ID 8729254073, 40 clinicians

Practice addresses (Care Compare)

5620 Read Blvd
New Orleans, LA 70127-3106
Phone (504) 592-6600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN123033-AP06528LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Nov 15, 2011 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Jan 13, 2013 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Jan 13, 2013 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Ochsner Clinic LLC CurrentSince Nov 15, 2011 Accepting new patients
Belle Chasse Emergency Group LLC Nurse Practitioner CurrentSince Feb 15, 2014 Accepting new patients
Foucher Emergency Group LLC Nurse Practitioner CurrentSince Feb 3, 2015 Accepting new patients
Grosbeak Emergency Physicians LLC Past Accepting new patients

Locations

1401 Foucher St
New Orleans, LA 70115
Phone (504) 897-7011

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

1514 Jefferson Hwy
New Orleans, LA 70121

5620 Read Blvd
New Orleans, LA 70127
Phone (504) 241-2664

100 Medical Center Dr
Slidell, LA 70461
Phone (504) 392-3131

2500 Belle Chasse Hwy
Terrytown, LA 70056
Phone (504) 391-5157

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1083993836",
    "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": "504-842-9119",
            "fax_number": "504-842-6997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 BELLE CHASSE HWY",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "70056",
            "telephone_number": "504-391-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBOUP BROWN",
        "first_name": "ADIAHA",
        "middle_name": "NJERI",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-10",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "RN123033-AP06528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02050390",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2169734",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, LA

Sources for this page

Verify at the official NPI Registry.