Active NPI
Jeffery Vezain
- Psychiatric/Mental Health Nurse Practitioner
- Slidell, LA
National Provider Identifier
1386263853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 211592
- Practice address
- 113 Christian LN
Slidell, LA 70458-1377 - Phone
- (866) 530-6111
- NPI assigned
- Apr 14, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 211592 | LA | Primary |
Addresses
Primary practice location
113 Christian LN
Slidell, LA 70458-1377
Mailing address
2900 Indiana Ave
Kenner, LA 70065-4605
Phone (504) 575-3712
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220823000485 | LA | Order and Referring Only - Nurse Practitioner | 5890178941 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- jeffery.vezain.1@11331.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586822400000",
"number": "1386263853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2900 INDIANA AVE",
"city": "KENNER",
"state": "LA",
"postal_code": "700654605",
"telephone_number": "504-575-3712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 CHRISTIAN LN",
"city": "SLIDELL",
"state": "LA",
"postal_code": "704581377",
"telephone_number": "866-530-6111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VEZAIN",
"first_name": "JEFFERY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-14",
"last_updated": "2020-04-14",
"certification_date": "2020-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "LA",
"license": "211592",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Slidell, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.