Individual provider Active NPI

Jennifer Noelle Lettsome, MSN, AGNP-BC, WHNP-B

  • Adult Health Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1316397896
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
95005296 Issued in CA
Practice address
3743 S la Brea Ave
Los Angeles, CA 90016-5309
Phone
(323) 329-9900
NPI assigned
Jun 15, 2016
Last updated
Apr 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 95005296 CA Primary

Addresses

Primary practice location

3743 S la Brea Ave
Los Angeles, CA 90016-5309

Mailing address

3743 S la Brea Ave
Los Angeles, CA 90016-5309
Phone (323) 329-9900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20190408000808 CA Order and Referring Only - Nurse Practitioner 3274874904

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95005296CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Apla Health & Wellness Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1316397896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3743 S LA BREA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900165309",
            "telephone_number": "323-329-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3743 S LA BREA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900165309",
            "telephone_number": "323-329-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETTSOME",
        "first_name": "JENNIFER",
        "middle_name": "NOELLE",
        "name_prefix": "Ms.",
        "credential": "MSN, AGNP-BC, WHNP-B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-15",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95005296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.