Active NPI
Jennifer St. Romain, CPNP
- Pediatric Nurse Practitioner
- Kentwood, LA
National Provider Identifier
1376587014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- AP04910
- Practice address
- 721 Avenue G
Kentwood, LA 70444-2601 - Phone
- (985) 229-5501
- Fax
- (985) 229-6828
- NPI assigned
- Jun 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | AP04910 | LA | Primary |
Addresses
Primary practice location
721 Avenue G
Kentwood, LA 70444-2601
Mailing address
721 Avenue G
Kentwood, LA 70444-2601
Phone (985) 229-5501
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1369667 | Medicaid | LA |
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
- Certified Pediatric Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP04910 | LA | MD | Pediatric Nurse Practitioner |
Interoperability endpoints
- jennifer.stromain@shchc.directbygreenway.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321401600000",
"number": "1376587014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "721 AVENUE G",
"city": "KENTWOOD",
"state": "LA",
"postal_code": "704442601",
"telephone_number": "985-229-5501",
"fax_number": "985-229-5828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "721 AVENUE G",
"city": "KENTWOOD",
"state": "LA",
"postal_code": "704442601",
"telephone_number": "985-229-5501",
"fax_number": "985-229-6828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ST. ROMAIN",
"first_name": "JENNIFER",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-15",
"last_updated": "2011-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "LA",
"license": "AP04910",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1369667",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kentwood, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.