Active NPI
Jessica Marie Brignac, PHARMD
- Pharmacist
- Ponchatoula, LA
National Provider Identifier
1386077030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 019680
- Practice address
- 1100 W Pine St
Ponchatoula, LA 70454-3700 - Phone
- (985) 809-9842
- Fax
- (985) 809-9845
- NPI assigned
- Aug 16, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 019680 | LA | Primary |
Addresses
Primary practice location
1100 W Pine St
Ponchatoula, LA 70454-3700
Mailing address
1100 W Pine St
Ponchatoula, LA 70454-3700
Phone (985) 386-2421
Other names 1
- Jessica Marie Ross
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019680 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Louisiana CVS Pharmacy LLC | Past | Accepting new patients | |
| Louisiana CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
1100 W Pine St
Ponchatoula, LA 70454
Phone (985) 386-2421
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672012800000",
"number": "1386077030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 W PINE ST",
"city": "PONCHATOULA",
"state": "LA",
"postal_code": "704543700",
"telephone_number": "985-386-2421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 W PINE ST",
"city": "PONCHATOULA",
"state": "LA",
"postal_code": "704543700",
"telephone_number": "985-809-9842",
"fax_number": "985-809-9845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIGNAC",
"first_name": "JESSICA",
"middle_name": "MARIE",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-16",
"last_updated": "2022-12-26",
"certification_date": "2021-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "019680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "ROSS",
"middle_name": "MARIE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Ponchatoula, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.