Individual provider Active NPI

Jennifer Stevens Juneau, FNP

  • Family Nurse Practitioner
  • Ruston, LA
National Provider Identifier
1285981068
Registry record updated Aug 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP06980 Issued in LA
Practice address
902 Sherwood Dr
Ruston, LA 71270-2157
Phone
(318) 251-3774
Fax
(318) 251-0442
NPI assigned
Aug 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2012

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 AP06980 LA Primary

Addresses

Primary practice location

902 Sherwood Dr
Ruston, LA 71270-2157

Mailing address

902 Sherwood Dr
Ruston, LA 71270-2157
Phone (318) 251-3774

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
I20140609000277 LA Practitioner - Nurse Practitioner 3072737345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choudrant Primary Care LLCGroup PAC ID 1052757416, 2 clinicians

Practice addresses (Care Compare)

3845 Elm St
Choudrant, LA 71227-3017
Phone (318) 695-9200

Hospital & facility affiliations

  • Magnolia Home Health Care, Inc Home health agency, Arcadia, LA, CCN 197447
  • Northern Louisiana Medical Center Hospital, Ruston, LA, CCN 190086

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Choudrant Primary Care LLC Family CurrentSince Feb 23, 2024 Accepting new patients
Ralph a Brooks, M.D. LLC Past Accepting new patients

Locations

3845 Elm St
Ste 3
Choudrant, LA 71227
Phone (318) 695-9200

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EBIHDD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Choudrant Primary Care LLCChoudrant, LA, CCN 198937 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
W-2 Managing Employee (100%)
Sep 19, 2024
Sep 19, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1344556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344556800000",
    "number": "1285981068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 SHERWOOD DR",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712702157",
            "telephone_number": "318-251-3774",
            "fax_number": "318-251-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 SHERWOOD DR",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712702157",
            "telephone_number": "318-251-3774",
            "fax_number": "318-251-0442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNEAU",
        "first_name": "JENNIFER",
        "middle_name": "STEVENS",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-10",
        "last_updated": "2012-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP06980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruston, LA

Sources for this page

Verify at the official NPI Registry.