Individual provider Active NPI

Jessica Oalmann Manchester, APRN-CNP

  • Nurse Practitioner
  • Bogalusa, LA
National Provider Identifier
1275170847
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209156 Issued in LA
Practice address
433 Plaza St
Bogalusa, LA 70427-3729
Phone
(877) 485-4474
NPI assigned
Dec 3, 2019
Last updated
Dec 3, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209156 LA Primary

Addresses

Primary practice location

433 Plaza St
Bogalusa, LA 70427-3729

Mailing address

5000 Ambassador Caffery Pkwy Ste a
Lafayette, LA 70508-6984
Phone (337) 277-6355

Other practice location 1

2929 Highway 190
Mandeville, LA 70471-3298
Phone (877) 485-4474

Other practice location 2

1202 S Tyler St
Covington, LA 70433-2330
Phone (774) 854-4748

Other practice location 3

1900 Main St
Franklinton, LA 70438-3688
Phone (877) 485-4474

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
I20200116002018 LA Practitioner - Nurse Practitioner 4880029016 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Emergency Physician Partners LLC CurrentSince Jan 1, 2020 Accepting new patients
Washington Parish Emergency Physicians Group LLC CurrentSince Jan 1, 2020 Accepting new patients
St Tammany Emergency Physicians Group LLC CurrentSince Jan 1, 2020 Accepting new patients
Riverside Medical Center Current Accepting new patients

Locations

433 Plaza St
Bogalusa, LA 70427
Phone (985) 730-6700

1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743

2929 Highway 190
Mandeville, LA 70471
Phone (985) 773-1550

1900 Main St
Sheridan, LA 70438
Phone (985) 795-4294

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": "1575331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1275170847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 AMBASSADOR CAFFERY PKWY STE A",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086984",
            "telephone_number": "337-277-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 PLAZA ST",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704273729",
            "telephone_number": "877-485-4474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2929 Highway 190",
            "address_purpose": "LOCATION",
            "city": "Mandeville",
            "state": "LA",
            "postal_code": "704713298",
            "country_code": "US",
            "telephone_number": "877-485-4474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1202 S Tyler St",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "LA",
            "postal_code": "704332330",
            "country_code": "US",
            "telephone_number": "774-854-4748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1900 Main St",
            "address_purpose": "LOCATION",
            "city": "Franklinton",
            "state": "LA",
            "postal_code": "704383688",
            "country_code": "US",
            "telephone_number": "877-485-4474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCHESTER",
        "first_name": "JESSICA",
        "middle_name": "OALMANN",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-03",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "209156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bogalusa, LA

Sources for this page

Verify at the official NPI Registry.