Individual provider Active NPI

Jamie C. Landry, PH.D.

  • Psychologist
  • Covington, LA
National Provider Identifier
1114230828
Registry record updated Sep 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1065 Issued in LA
Practice address
70452 Highway 21
Suite 200 #116
Covington, LA 70433-8116
Phone
(504) 915-4121
NPI assigned
Jul 22, 2010
Last updated
Sep 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1065 LA Primary

Addresses

Primary practice location

70452 Highway 21
Suite 200 #116
Covington, LA 70433-8116

Mailing address

70452 Highway 21
Suite 200 #116
Covington, LA 70433-8116
Phone (504) 915-4121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1065LAMDChiropractor

Organizations & group practices 1

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": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1114230828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70452 HIGHWAY 21",
            "address_2": "SUITE 200 #116",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704338116",
            "telephone_number": "504-915-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70452 HIGHWAY 21",
            "address_2": "SUITE 200 #116",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704338116",
            "telephone_number": "504-915-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "JAMIE",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-22",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "LA",
            "license": "1065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; 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.