Organization Active NPI

Jennifer Rudd McCann MD, LLC

  • Obstetrics & Gynecology Physician
  • Deridder, LA
National Provider Identifier
1346915261
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
JENNIFER RUDD MCCANN MD, LLC
Practice address
401 S Washington St
Deridder, LA 70634-4863
Phone
(337) 515-4537
NPI assigned
Aug 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Authorized official

Name
Dr. Jennifer McCann, MDNPI 1083816854
Title
Owner
Phone
(337) 515-4537

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

401 S Washington St
Deridder, LA 70634-4863

Mailing address

401 S Washington St
Deridder, LA 70634-4863
Phone (337) 515-4537

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL mccann.wellness1@gmail.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211109001884 LA Part B Supplier - Clinic/Group Practice 2466841648 Receives reassigned benefits from 1 practitioner
Practice locations: Deridder, LA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2233236Jennifer Rudd McCann MD LLC401 S Washington St, Deridder, LA 70634Certificate of waiverAug 19, 2027

National Provider Directory

National Provider Directory

Locations

401 S Washington St
Deridder, LA 70634
Phone (337) 515-4537

1 Medical Plaza Pl
Minden, LA 71055
Phone (318) 371-4042

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1346915261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S WASHINGTON ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344863",
            "telephone_number": "337-515-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S WASHINGTON ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344863",
            "telephone_number": "337-515-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER RUDD MCCANN MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-12",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A",
        "authorized_official_last_name": "MCCANN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-515-4537",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mccann.wellness1@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "401 S Washington St",
            "city": "Deridder",
            "state": "LA",
            "country_code": "US",
            "postal_code": "706344863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Deridder, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.