NPIMap

Organization Active NPI

Jens F Graversen MD Apm LLC

  • Urology Physician
  • Hammond, LA
National Provider Identifier
1457529679
Registry record updated Jun 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD200326 Issued in LA
Legal business name
JENS F GRAVERSEN MD APM LLC
Practice address
15770 Paul Vega MD Dr
Ste 200
Hammond, LA 70403-1475
Phone
(985) 542-1226
Fax
(985) 542-2887
NPI assigned
Feb 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Tammy Harris
Title
Office Manager
Phone
(985) 542-1226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X MD200326 LA Primary

Addresses

Primary practice location

15770 Paul Vega MD Dr
Ste 200
Hammond, LA 70403-1475

Mailing address

15770 Paul Vega MD Dr
Ste 200
Hammond, LA 70403-1475
Phone (985) 542-1226

Other identifiers 1

IdentifierTypeStateIssuer
1598551MedicaidLA

National Provider Directory

National Provider Directory

Locations

15770 Paul Vega Md Dr
Ste 200
Hammond, LA 70403
Phone (985) 542-1226

15770 Paul Vega Md Dr
Hammond, LA 70403
Phone (985) 230-7860

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212537600000",
    "number": "1457529679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15770 PAUL VEGA MD DR",
            "address_2": "STE 200",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031475",
            "telephone_number": "985-542-1226",
            "fax_number": "985-542-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15770 PAUL VEGA MD DR",
            "address_2": "STE 200",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031475",
            "telephone_number": "985-542-1226",
            "fax_number": "985-542-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENS F GRAVERSEN MD APM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-06-04",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "985-542-1226",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "LA",
            "license": "MD200326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598551",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.