Active NPI
Jennesia M Primas
- Dentist
- New Orleans, LA
National Provider Identifier
1396138780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6580
- Practice address
- 611 Okeefe Ave Apt 5N29
New Orleans, LA 70113-1986 - Phone
- (404) 626-5989
- NPI assigned
- Mar 10, 2015
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 6580 | LA | Primary |
Addresses
Primary practice location
611 Okeefe Ave Apt 5N29
New Orleans, LA 70113-1986
Mailing address
611 Okeefe Ave Apt 5N29
New Orleans, LA 70113-1986
Phone (404) 626-5989
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151123002454 | LA | Order and Referring Only - Dentist | 6406156488 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6580 | LA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433980800000",
"number": "1396138780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 OKEEFE AVE APT 5N29",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701131986",
"telephone_number": "404-626-5989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 OKEEFE AVE APT 5N29",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701131986",
"telephone_number": "404-626-5989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIMAS",
"first_name": "JENNESIA",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-10",
"last_updated": "2015-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "6580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Orleans, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; 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.