Active NPI
Jessica Clark
- Case Manager/Care Coordinator
- Slidell, LA
National Provider Identifier
1154214799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 1154214799
- Practice address
- 118 Village St
Slidell, LA 70458-5302 - Phone
- (985) 781-4444
- NPI assigned
- Jun 2, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 1154214799 | LA | Primary |
Addresses
Primary practice location
118 Village St
Slidell, LA 70458-5302
Mailing address
8326 Kelwood Ave
Baton Rouge, LA 70806-4803
Phone (985) 781-4444
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1154214799 | LA | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749772800000",
"number": "1154214799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8326 KELWOOD AVE",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708064803",
"telephone_number": "985-781-4444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 VILLAGE ST",
"city": "SLIDELL",
"state": "LA",
"postal_code": "704585302",
"telephone_number": "985-781-4444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-02",
"last_updated": "2025-06-13",
"certification_date": "2025-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "LA",
"license": "1154214799",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Slidell, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.