NPIMap

Organization Active NPI

Jefferson Community Health Care Centers Inc

  • General Practice Physician
  • Avondale, LA
National Provider Identifier
1124000773
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
JEFFERSON COMMUNITY HEALTH CARE CENTERS INC
Practice address
4028 Highway 90 W
Avondale, LA 70094-2622
Phone
(504) 436-2223
Fax
(504) 436-2224
NPI assigned
Nov 18, 2005
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Miss Stacey Marie Lovell
Title
Billing Office/Credentialing
Phone
(504) 436-2223

Practitioners 1

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

National Provider Directory

National Provider Directory
Tax ID family
Inclusivcare16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

4028 Highway 90 W
Avondale, LA 70094-2622

Mailing address

4028 Highway 90 W
Avondale, LA 70094-2622
Phone (504) 436-2223

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1447196MedicaidLA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124000773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4028 HIGHWAY 90 W",
            "city": "AVONDALE",
            "state": "LA",
            "postal_code": "700942622",
            "telephone_number": "504-436-2223",
            "fax_number": "504-436-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4028 HIGHWAY 90 W",
            "city": "AVONDALE",
            "state": "LA",
            "postal_code": "700942622",
            "telephone_number": "504-436-2223",
            "fax_number": "504-436-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COMMUNITY HEALTH CARE CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOVELL",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "BILLING OFFICE/CREDENTIALING",
        "authorized_official_telephone_number": "504-436-2223",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447196",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, 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.