Active NPI
Jean-Claude Loiseau, M.D.
- Surgery Physician
- Memphis, TN
National Provider Identifier
1467453720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 30033
- Practice address
- 1264 Wesley Dr
Ste 304
Memphis, TN 38116-6400 - Phone
- (901) 398-1990
- Fax
- (901) 398-1996
- NPI assigned
- Aug 9, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 30033 | TN | Primary |
| Surgery Physician | 208600000X | 17160 | MS | |
| Surgery Physician | 208600000X | 35045444L | OH |
Addresses
Primary practice location
1264 Wesley Dr
Ste 304
Memphis, TN 38116-6400
Mailing address
1264 Wesley Dr
Ste 304
Memphis, TN 38116-6400
Phone (901) 398-1990
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0122348 | Medicaid | MS | |
| 9015315 | Medicaid | MS | |
| 0482986007 | Other | CIGNA ID # | |
| 3088094 | Other | TN | BC BS # |
| 4280919 | Other | TN | AETNA ID # |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17160 | MS | MD | Surgery Physician |
| 35045444L | OH | MD | Surgery Physician |
| 30033 | TN | MD | Surgery Physician |
Interoperability endpoints
- slievense@wih.cernerdirect.carene.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318550400000",
"number": "1467453720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1264 WESLEY DR",
"address_2": "STE 304",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381166400",
"telephone_number": "901-398-1990",
"fax_number": "901-398-1996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1264 WESLEY DR",
"address_2": "STE 304",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381166400",
"telephone_number": "901-398-1990",
"fax_number": "901-398-1996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOISEAU",
"first_name": "JEAN-CLAUDE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-09",
"last_updated": "2011-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TN",
"license": "30033",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MS",
"license": "17160",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OH",
"license": "35045444L",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0122348",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9015315",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA ID #",
"identifier": "0482986007",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS #",
"identifier": "3088094",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA ID #",
"identifier": "4280919",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.