Individual provider Active NPI

Jaimie Alechia Treadway Harris, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Bastrop, LA
National Provider Identifier
1184308371
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
202258 Issued in LA
Practice address
420 Gunby Ave
Bastrop, LA 71220-4406
Phone
(318) 283-3920
NPI assigned
Jun 9, 2023
Last updated
Jan 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 202258 LA Primary

Addresses

Primary practice location

420 Gunby Ave
Bastrop, LA 71220-4406

Mailing address

PO Box 1060
Bastrop, LA 71221-1060
Phone (318) 283-3600

Other practice location 1

323 W Walnut Ave
Bastrop, LA 71220-4521
Phone (318) 283-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230914002593 LA Practitioner - Nurse Practitioner 3577927128 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Access Serenity of Louisiana LLCGroup PAC ID 4385985803, 13 clinicians

Practice addresses (Care Compare)

414 Pine St
Monroe, LA 71201-6228
Phone (337) 802-1336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Access Serenity of Louisiana, LLC CurrentSince Jul 22, 2024 Accepting new patients
Morehouse General Hospital CurrentSince Jul 1, 2023 Accepting new patients
Morehouse General Hospital CurrentSince Jul 1, 2023 Accepting new patients

Locations

323 W Walnut Ave
Bastrop, LA 71220
Phone (318) 283-3600

4673 Eugene Ware Blvd
Bastrop, LA 71220
Phone (318) 281-2448

110 W 4th St
Dequincy, LA 70633
Phone (337) 363-9470

2837 Ernest St
Ste C
Lake Charles, LA 70601
Phone (337) 274-2689

414 Pine St
Monroe, LA 71201
Phone (318) 281-2448

Organizations & group practices 3

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": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1184308371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1060",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712211060",
            "telephone_number": "318-283-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 GUNBY AVE",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712204406",
            "telephone_number": "318-283-3920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "323 W Walnut Ave",
            "address_purpose": "LOCATION",
            "city": "Bastrop",
            "state": "LA",
            "postal_code": "712204521",
            "country_code": "US",
            "telephone_number": "318-283-3900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TREADWAY HARRIS",
        "first_name": "JAIMIE",
        "middle_name": "ALECHIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-09",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "202258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bastrop, LA

Sources for this page

Verify at the official NPI Registry.