Individual provider Active NPI

Jamila Staples, MD

  • Pediatrics Physician
  • Macon, GA
National Provider Identifier
1326675851
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
12145 Issued in GA
Practice address
888 Pine St
Macon, GA 31201-2109
Phone
(678) 895-8585
NPI assigned
Mar 25, 2020
Last updated
Aug 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 12145 GA Primary

Addresses

Primary practice location

888 Pine St
Macon, GA 31201-2109

Mailing address

777 Hemlock St
Macon, GA 31201-2102
Phone (678) 895-8585

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240325002307 LA Practitioner - Pediatric Medicine 1658718713 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12145GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Teche Action Board Inc Current Accepting new patients
Teche Action Board, Inc. CurrentSince Mar 1, 2024 Accepting new patients
Teche Action Board, Inc. CurrentSince Mar 1, 2024 Accepting new patients
Teche Action Board Inc Past Accepting new patients
Teche Action Board, Inc. Past Accepting new patients
Teche Action Board, Inc. Past Accepting new patients
Teche Action Board, Inc. Past Accepting new patients
Teche Action Board, Inc. Past Accepting new patients

Locations

18333 Highway 182
Rm 505
Baldwin, LA 70514
Phone (337) 924-9418

159 E 3rd St
Edgard, LA 70049
Phone (985) 497-8726

2555 Highway 18
Edgard, LA 70049
Phone (337) 828-2550

1115 Weber St
Franklin, LA 70538
Phone (337) 828-2550

827 N Pine St
Gramercy, LA 70052
Phone (225) 258-9490

1014 W Tunnel Blvd
Houma, LA 70360
Phone (985) 851-1717

189 Mozart Dr
Houma, LA 70363
Phone (985) 868-3700

5642 W Main St
Houma, LA 70360
Phone (985) 448-3737

393 Greenwood Dr
La Place, LA 70068
Phone (985) 359-6492

1124 7th St
Morgan City, LA 70380
Phone (985) 384-2371

3528 Highway 70 S
Pierre Part, LA 70339
Phone (985) 252-6211

1709 Ridgefield Rd
Thibodaux, LA 70301
Phone 33782825502144

22187 Highway 20
Vacherie, LA 70090
Phone (225) 258-4980

Organizations & group practices 9

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": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1326675851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "678-895-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 PINE ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012109",
            "telephone_number": "678-895-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAPLES",
        "first_name": "JAMILA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "12145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.