Individual provider Active NPI

Jessica M Pearson

  • Family Nurse Practitioner
  • Columbia, LA
National Provider Identifier
1184934002
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP06287 Issued in LA
Practice address
8064 Highway 165
Columbia, LA 71418-3396
Phone
(318) 649-6766
Fax
(318) 649-2353
NPI assigned
Oct 13, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP06287 LA Primary

Addresses

Primary practice location

8064 Highway 165
Columbia, LA 71418-3396

Mailing address

166 Gates St
Columbia, LA 71418-4232
Phone (318) 649-3457

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
I20110316000110 LA Practitioner - Nurse Practitioner 3577745363 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lasalle Parish Hospital Service Dist No1 CurrentSince Jun 6, 2022 Accepting new patients
Lasalle Parish Hospital Service District #1 CurrentSince Jun 6, 2022 Accepting new patients
Jimmy R Coughran a Medical Corporation CurrentSince Feb 1, 2011 Accepting new patients
Lasalle Hospital Service Dist #1 Past Accepting new patients

Locations

1010 Davis Lake Rd
Columbia, LA 71418
Phone (318) 649-3766

8064 Highway 165
Columbia, LA 71418
Phone (318) 649-6766

1049 N Pine Rd
Olla, LA 71465
Phone (318) 495-3175

1102 N Pine Rd
Olla, LA 71465
Phone (318) 495-5302

2106 Loop Rd
Ste A
Winnsboro, LA 71295
Phone (318) 435-6363

Organizations & group practices 4

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": "1286928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1184934002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 GATES ST",
            "city": "COLUMBIA",
            "state": "LA",
            "postal_code": "714184232",
            "telephone_number": "318-649-3457",
            "fax_number": "318-649-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8064 HIGHWAY 165",
            "city": "COLUMBIA",
            "state": "LA",
            "postal_code": "714183396",
            "telephone_number": "318-649-6766",
            "fax_number": "318-649-2353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "JESSICA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-13",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP06287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, LA

Sources for this page

Verify at the official NPI Registry.