Individual provider Active NPI

Janet Ruth Juracovich, ANP-BC

  • Adult Health Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1124327630
Registry record updated May 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP06340 Issued in LA
Practice address
121 Rue Louis Xiv BLDG 4
Suite B
Lafayette, LA 70508-5738
Phone
(337) 984-9355
Fax
(337) 984-9592
NPI assigned
Mar 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN063196-AP06340 LA
Registered Nurse 163W00000X RN063196 LA
Adult Health Nurse Practitioner 363LA2200X AP06340 LA Primary

Addresses

Primary practice location

121 Rue Louis Xiv BLDG 4
Suite B
Lafayette, LA 70508-5738

Mailing address

121 Rue Louis Xiv BLDG 4
Suite B
Lafayette, LA 70508-5738
Phone (337) 984-9355

Other identifiers 1

IdentifierTypeStateIssuer
2196391MedicaidLA

Other names 1

  • Ms. Jan Ruth Juracovich Professional name

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN063196LAMDRegistered Nurse
AP06340LAMDAdult Health Nurse Practitioner
RN063196-AP06340LAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neurological Associates of Louisiana, L.L.C. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399939200000",
    "number": "1124327630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 RUE LOUIS XIV BLDG 4",
            "address_2": "SUITE B",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085738",
            "telephone_number": "337-984-9355",
            "fax_number": "337-984-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 RUE LOUIS XIV BLDG 4",
            "address_2": "SUITE B",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085738",
            "telephone_number": "337-984-9355",
            "fax_number": "337-984-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURACOVICH",
        "first_name": "JANET",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-23",
        "last_updated": "2014-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "LA",
            "license": "RN063196-AP06340",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN063196",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "LA",
            "license": "AP06340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2196391",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAN",
            "last_name": "JURACOVICH",
            "middle_name": "RUTH",
            "prefix": "MS.",
            "credential": "ANP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; 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.