Individual provider Active NPI

Ross Campbell Dejarnatt

  • Student in an Organized Health Care Education/Training Program
  • New Orleans, LA
National Provider Identifier
1104453620
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2000 Canal St
New Orleans, LA 70112-3018
Phone
(504) 702-3000
NPI assigned
Mar 25, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2000 Canal St
New Orleans, LA 70112-3018

Mailing address

2401 S 31St St
Temple, TX 76508-0001
Phone (254) 724-0108

Other practice location 1

2401 S 31st St
Temple, TX 76508-0001
Phone (254) 724-0108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260610003787 TX Order and Referring Only - Interventional CardiologyPractitioner - Interventional Cardiology 1759853781

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1104453620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "254-724-0108",
            "fax_number": "254-724-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 CANAL ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701123018",
            "telephone_number": "504-702-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 S 31st St",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765080001",
            "country_code": "US",
            "telephone_number": "254-724-0108",
            "fax_number": "254-724-8067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEJARNATT",
        "first_name": "ROSS",
        "middle_name": "CAMPBELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.