Active NPI
Jesse Jermaine Harrison, CST
- Surgical Technologist
- Baton Rouge, LA
National Provider Identifier
1114258779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- Practice address
- 17915 Glen Park Dr
Baton Rouge, LA 70817-9582 - Phone
- (225) 275-3866
- NPI assigned
- Jan 21, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Technologist | 246ZS0410X | Primary |
Addresses
Primary practice location
17915 Glen Park Dr
Baton Rouge, LA 70817-9582
Mailing address
17915 Glen Park Dr
Baton Rouge, LA 70817-9582
Phone (225) 275-3866
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264032000000",
"number": "1114258779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17915 GLEN PARK DR",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708179582",
"telephone_number": "225-275-3866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17915 GLEN PARK DR",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708179582",
"telephone_number": "225-275-3866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "JESSE",
"middle_name": "JERMAINE",
"credential": "CST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-01-21",
"last_updated": "2010-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.