Jencare Neighborhood Medical Metairie, LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHY.007546-IR Issued in LA

Legal business name

JENCARE NEIGHBORHOOD MEDICAL METAIRIE, LLC

Practice address

3530 Houma Boulevard
Jencare Neighborhood Medical Metairie #2
Metairie, LA 70006

Phone

(305) 628-6117

Fax

(305) 831-4408

NPI assigned

Aug 7, 2017

Last updated

Apr 10, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

PMR LA HOLDING, LLCAs reported in NPPES

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

Authorized official

Name

Gordon L Chen, M.D.

Title

Officer

Phone

(305) 628-6117

Specialties & licenses 2

Addresses

Other names 1

• JenCare Neighborhood Medical Metairie#2 Other name

Tax ID family

Jencare Neighborhood Medical Center Uptown2 organizations share this tax ID, including this one

Part of

PMR la Holding LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jencare Neighborhood Medical Metairie, LLC.

  • Specialist
  • New Orleans, LA
  • NPI 1356854103
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• PMR la Holding, LLC

  • Specialist
  • New Orleans, LA
  • NPI 1386900868
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wallace Jeanfreau Jr., M.D.

  • Internal Medicine Physician
  • Metairie, LA
  • NPI 1518065978
  NPD (past)

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

{
    "created_epoch": "1502064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523318400000",
    "number": "1104341544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 N.W. 167TH STREET",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "33169",
            "telephone_number": "305-628-6117",
            "fax_number": "305-831-4408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 HOUMA BOULEVARD",
            "address_2": "JENCARE NEIGHBORHOOD MEDICAL METAIRIE #2",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70006",
            "telephone_number": "305-628-6117",
            "fax_number": "305-831-4408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENCARE NEIGHBORHOOD MEDICAL METAIRIE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PMR LA HOLDING, LLC",
        "enumeration_date": "2017-08-07",
        "last_updated": "2018-04-10",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "305-628-6117",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "LA",
            "license": "PHY.007546-IR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JenCare Neighborhood Medical Metairie#2",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Hannah Jefferson
• Kennedy Makenzie Jefferson
• Kenya Jefferson
• Jeffrey B Karas LLC
• Jeffrey Singer, MD (Apmc)
• Jencare Neighborhood Medical Metairie, LLC
• Lawrence C Jenkins, MD, MBA
• Pierce Jenkins
• Shantell Jenkins
• Shawn Viverette Jenkins, LPN

• Pharmacy in Metairie, LA
• Providers in Metairie, LA by specialty
• Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; 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.