Individual provider Active NPI

Jacklyn Lee Lemoine, APRN

  • Family Nurse Practitioner
  • Baton Rouge, LA
National Provider Identifier
1255721619
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP08153 Issued in LA
Practice address
5000 Hennessy Blvd
ER Dept
Baton Rouge, LA 70808-4375
Phone
(225) 765-7163
Fax
(405) 844-1794
NPI assigned
Jan 23, 2015
Last updated
Jan 23, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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 AP08153 LA Primary

Addresses

Primary practice location

5000 Hennessy Blvd
ER Dept
Baton Rouge, LA 70808-4375

Mailing address

Dept At952639
Atlanta, GA 31192-2639
Phone (225) 765-7163

Other names 1

  • Jacklyn Lee Lemoine-Lott Other name

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
I20150206001212 LA Practitioner - Nurse Practitioner 4688999030 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Emergency Physician Associates, LLCGroup PAC ID 1759317092, 78 clinicians

Practice addresses (Care Compare)

5000 Hennessy Blvd
Baton Rouge, LA 70808-4375
Phone (225) 765-8826

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Woman's Assessment Center Physicians CurrentSince Jan 1, 2018 Accepting new patients
Mayfair Emergency Group, LLC Nurse Practitioner CurrentSince Jul 22, 2018 Accepting new patients
Professional Emergency Physician Associates, LLC CurrentSince Jan 21, 2015 Accepting new patients
Abbeville Emergency Group LLC Nurse Practitioner CurrentSince Nov 10, 2015 Accepting new patients

Locations

Dept AT952639
Atlanta, GA 31192

118 N Hospital Dr
Abbeville, LA 70510
Phone (337) 893-5466

17000 Medical Center Dr
Baton Rouge, LA 70816
Phone (225) 752-2470

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

5000 Hennessy Blvd
Ste B
Baton Rouge, LA 70808

5439 Airline Hwy
Baton Rouge, LA 70805
Phone (225) 358-2280

100 Womans Way
Baton Rouge, LA 70817
Phone (225) 293-2324

5000 Odonavan Blvd
Walker, LA 70785
Phone (225) 214-4200

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, 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": "1421971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1255721619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT AT952639",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311922639",
            "telephone_number": "225-765-7163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 HENNESSY BLVD",
            "address_2": "ER DEPT",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084375",
            "telephone_number": "225-765-7163",
            "fax_number": "405-844-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMOINE",
        "first_name": "JACKLYN",
        "middle_name": "LEE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-23",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP08153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKLYN",
            "last_name": "LEMOINE-LOTT",
            "middle_name": "LEE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.