Dakota Frederick Jenneman, DO

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

343254 Issued in LA

Practice address

4809 Ambassador Caffery Pkwy Ste 230
Lafayette, LA 70508-8800

Phone

(337) 470-0014

Fax

(337) 470-6495

NPI assigned

Mar 27, 2018

Last updated

Aug 2, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NC, LA2 enrollments

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 2

Specialty

Hematology/Oncology

Education

William Carey University College of Osteopathic Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Our Lady of Lourdes Regional Medical Center, Inc.Group PAC ID 5890683411, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Our Lady of Lourdes Regional Medical Center, Inc Hospital, Lafayette, LA, CCN 190102
• Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002
• Iberia Medical Center Hospital, New Iberia, LA, CCN 190054
• Opelousas General Health System Hospital, Opelousas, LA, CCN 190017

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: djenneman5296637@direct.casso.us.com
• Direct secure messaging: djenneman536564@carolinashealthcaresystem.direct-ci.com

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.

• Our Lady of Lourdes Regional Medical Center Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1952497489
  Medicare reassignment Care Compare group NPD
• The Charlotte-Mecklenburg Hospital Authority

  dba Levine Cancer Institute

  • Medical Oncology Physician
  • Indian Land, SC
  • NPI 1669738829

  Internal Medicine, NC

  Medicare reassignment NPD
• Our Lady of Lourdes Regional Medical Center

  • Emergency Medicine Physician
  • Lafayette, LA
  • NPI 1538181128
  NPD
• The Charlotte-Mecklenburg Hospital Authority

  dba Levine Cancer Institute

  • Surgical Oncology Physician
  • Charlotte, NC
  • NPI 1508135799

  Internal Medicine

  NPD
• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Pineville Rehabilitation Hospital

  • Rehabilitation Hospital Unit
  • Charlotte, NC
  • NPI 1962987131
  NPD

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

• Hospital Service District No 1 of Iberia Parish

  dba Iberia Medical Center

  • Rehabilitation Hospital Unit
  • New Iberia, LA
  • NPI 1992159925
  Care Compare affiliation
• Hospital Service District No. 1 of Iberia Parish

  dba Iberia Medical Center

  • General Acute Care Hospital
  • New Iberia, LA
  • NPI 1285601088
  Care Compare affiliation
• Lafayette General Medical Center Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1275536799
  Care Compare affiliation
• Opelousas General Hospital Authority

  • General Acute Care Hospital
  • Opelousas, LA
  • NPI 1447230388
  Care Compare affiliation
• Our Lady of Lourdes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1598766495
  Care Compare affiliation

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1356846778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "337-470-0014",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4809 AMBASSADOR CAFFERY PKWY STE 230",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705088800",
            "telephone_number": "337-470-0014",
            "fax_number": "337-470-6495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Medical Park Dr",
            "address_2": "Ste 110",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252948",
            "country_code": "US",
            "telephone_number": "704-403-1370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "945 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Albemarle",
            "state": "NC",
            "postal_code": "280013417",
            "country_code": "US",
            "telephone_number": "980-323-7790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1021 Morehead Medical Dr",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042990",
            "country_code": "US",
            "telephone_number": "980-442-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "340 Jake Alexander Blvd W",
            "address_2": "Ste 101",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281471364",
            "country_code": "US",
            "telephone_number": "704-403-4900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4525 Cameron Valley Pkwy",
            "address_2": "Ste 3500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282114369",
            "country_code": "US",
            "telephone_number": "704-302-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENNEMAN",
        "first_name": "DAKOTA",
        "middle_name": "FREDERICK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-27",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2021-02475",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "2021-02475",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "LA",
            "license": "343254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "djenneman536564@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "340 Jake Alexander Blvd W",
            "address_2": "Ste 101",
            "city": "Salisbury",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281471364",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Morgan Jeknavorian, RRT
• David Jenkins, M.D.
• Jami Jenkins, PHARMD,RPH
• Nkenge Jenkins, LPC
• Patsy Jenkins, NP
• Jennifer R. Vines LCSW Inc
• Jennings Family Chiropractic Clinic Inc. (Dr Kevin's Wellness Clinic)
• Amanda Jennings, FNP
• Charmaine Jennings
• Jamiri Jakeishia Jennings, MS, CGC

• Hematology & Oncology Physician in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Hematology & Oncology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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; Order and Referring.
• 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.