Individual provider Active NPI

Jerrel Stills

  • Case Manager/Care Coordinator
  • Monroe, LA
National Provider Identifier
1285131326
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
296 Forest Oaks Rd
Monroe, LA 71202
Phone
(318) 402-9035
NPI assigned
Apr 6, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

296 Forest Oaks Rd
Monroe, LA 71202

Mailing address

296 Forest Oaks Rd
Monroe, LA 71202-7530

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1285131326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 FOREST OAKS RD",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712027530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 FOREST OAKS RD",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "71202",
            "telephone_number": "318-402-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLS",
        "first_name": "JERREL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-06",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.