Individual provider Active NPI

Cornel Joseph Jeansonne, M.D.

  • Pediatrics Physician
  • Slidell, LA
National Provider Identifier
1477572543
Registry record updated May 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD014412 Issued in LA
Practice address
1430 Lindberg Dr
Slidell, LA 70458-8056
Phone
(985) 781-7337
Fax
(985) 781-7339
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD014412 LA Primary

Addresses

Primary practice location

1430 Lindberg Dr
Slidell, LA 70458-8056

Mailing address

1430 Lindberg Dr
Slidell, LA 70458-8056
Phone (985) 781-7337

Other identifiers 1

IdentifierTypeStateIssuer
1347671MedicaidLA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD014412LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S International L.L.C. Pediatrics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306368000000",
    "number": "1477572543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 LINDBERG DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704588056",
            "telephone_number": "985-781-7337",
            "fax_number": "985-781-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 LINDBERG DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704588056",
            "telephone_number": "985-781-7337",
            "fax_number": "985-781-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEANSONNE",
        "first_name": "CORNEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2011-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD014412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1347671",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.

Verify at the official NPI Registry.