NP Mom LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

NP MOM LLC

Practice address

1921 Kaliste Saloom Rd Ste 117
Lafayette, LA 70508-6183

Phone

(337) 210-5827

Fax

(844) 482-4077

NPI assigned

Aug 13, 2024

Organization subpart

No

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

Authorized official

Name

Kelly Ducharme Jacobs, NPNPI 1447092630

Title

Owner

Phone

(337) 210-5827

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly D Jacobs, FNP

  • Family Nurse Practitioner
  • Lafayette, LA
  • NPI 1447092630
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1467283184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 KALISTE SALOOM RD STE 117",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086183",
            "telephone_number": "337-210-5827",
            "fax_number": "844-482-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 KALISTE SALOOM RD STE 117",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086183",
            "telephone_number": "337-210-5827",
            "fax_number": "844-482-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NP MOM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "DUCHARME",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-210-5827",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.