NPIMap

Organization Active NPI

West Jefferson Physician Services

  • Internal Medicine Physician
  • Harvey, LA
National Provider Identifier
1114092194
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WEST JEFFERSON PHYSICIAN SERVICES
Practice address
2845 Manhattan Blvd
Harvey, LA 70058-2987
Phone
(504) 349-6930
Fax
(504) 361-5496
NPI assigned
Nov 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Heidi A Gwinn
Title
Credentialing Coord.
Phone
(504) 349-1297

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2845 Manhattan Blvd
Harvey, LA 70058-2987

Mailing address

2845 Manhattan Blvd
Harvey, LA 70058-2987
Phone (504) 349-6930

Other identifiers 1

IdentifierTypeStateIssuer
1942545MedicaidLA

Other names 1

  • Family Doctors Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Doctors7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

2845 Manhattan Blvd
Harvey, LA 70058
Phone (504) 349-6930

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114092194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 MANHATTAN BLVD",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700582987",
            "telephone_number": "504-349-6930",
            "fax_number": "504-361-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 MANHATTAN BLVD",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700582987",
            "telephone_number": "504-349-6930",
            "fax_number": "504-361-5496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST JEFFERSON PHYSICIAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GWINN",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING COORD.",
        "authorized_official_telephone_number": "504-349-1297"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942545",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Doctors",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harvey, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.