Active NPI
Kemja Bettis
- Case Manager/Care Coordinator
- Monore, LA
National Provider Identifier
1417328246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 12845
- Practice address
- 1900 N 18TH St, Morore, la
Monore, LA 71201 - Phone
- (720) 633-0949
- NPI assigned
- Oct 20, 2015
- Last updated
- Nov 16, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 12845 | LA | |
| Case Manager/Care Coordinator | 171M00000X | 12845 | LA | Primary |
Addresses
Primary practice location
1900 N 18TH St, Morore, la
Monore, LA 71201
Mailing address
4325 Clubhouse Dr Apt H2
Alexandria, LA 71303-3572
Phone (720) 633-0949
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12845 | LA | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542326400000",
"number": "1417328246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4325 CLUBHOUSE DR APT H2",
"city": "ALEXANDRIA",
"state": "LA",
"postal_code": "713033572",
"telephone_number": "720-633-0949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 N 18TH ST, MORORE, LA",
"city": "MONORE",
"state": "LA",
"postal_code": "71201",
"telephone_number": "720-633-0949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETTIS",
"first_name": "KEMJA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-20",
"last_updated": "2018-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "LA",
"license": "12845",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "LA",
"license": "12845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.