Individual provider Active NPI

Jeffrey Michael Bahan, R.N.

  • Registered Nurse
  • Metairie, LA
National Provider Identifier
1366715864
Registry record updated Feb 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
132113 Issued in LA
Practice address
2637 Edenborn Ave
Suite 301
Metairie, LA 70002-7045
Phone
(504) 455-2446
NPI assigned
Feb 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 132113 LA Primary

Addresses

Primary practice location

2637 Edenborn Ave
Suite 301
Metairie, LA 70002-7045

Mailing address

1209 Pasadena Ave
Metairie, LA 70001-3562
Phone (504) 208-7115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
132113LAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1366715864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 PASADENA AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700013562",
            "telephone_number": "504-208-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2637 EDENBORN AVE",
            "address_2": "SUITE 301",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700027045",
            "telephone_number": "504-455-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHAN",
        "first_name": "JEFFREY",
        "middle_name": "MICHAEL",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-14",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "132113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.