Individual provider Active NPI

James J Jang, MD

  • Pediatrics Physician
  • Marrero, LA
National Provider Identifier
1477648012
Registry record updated Feb 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
025790 Issued in LA
Practice address
1101 Medical Ctr. Blvd.
Pediatric ER
Marrero, LA 70072
Phone
(504) 349-1554
Fax
(504) 349-1579
NPI assigned
Oct 3, 2006
Last updated
Feb 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 28497 SC
Pediatrics Physician 208000000X 025790 LA Primary

Addresses

Primary practice location

1101 Medical Ctr. Blvd.
Pediatric ER
Marrero, LA 70072

Mailing address

1101 Medical Ctr. Blvd.
Pediatric ER
Marrero, LA 70072
Phone (504) 349-1554

Other identifiers 2

IdentifierTypeStateIssuer
1047040MedicaidLA
278312600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131226001269 LA Practitioner - Pediatric Medicine 5395808505 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
025790LAMDPediatrics Physician
28497SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Convenient Care LLC Current Accepting new patients
Convenient Care LLC CurrentSince Oct 9, 2013 Accepting new patients
Lake Urgent Care Ascension LLC CurrentSince Apr 22, 2020 Accepting new patients
Lake Urgent Care Ascension LLC CurrentSince Apr 22, 2020 Accepting new patients
Convenient Care LLC CurrentSince Oct 9, 2013 Accepting new patients

Locations

10319 Jefferson Hwy
Baton Rouge, LA 70809
Phone (224) 214-9352

12525 Perkins Rd
#B
Baton Rouge, LA 70810
Phone (225) 819-8857

1776 N Airline Hwy
Ste A
Gonzales, LA 70737
Phone (225) 647-4988

14350 Highway 73
Prairieville, LA 70769
Phone (225) 313-3930

40546 Highway 42
Prairieville, LA 70769
Phone (225) 744-4988

10714 Highway 431
Saint Amant, LA 70774
Phone (225) 644-0005

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392595200000",
    "number": "1477648012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MEDICAL CTR. BLVD.",
            "address_2": "PEDIATRIC ER",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "70072",
            "telephone_number": "504-349-1554",
            "fax_number": "504-349-1579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MEDICAL CTR. BLVD.",
            "address_2": "PEDIATRIC ER",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "70072",
            "telephone_number": "504-349-1554",
            "fax_number": "504-349-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANG",
        "first_name": "JAMES",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2014-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "28497",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "025790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1047040",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278312600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

Verify at the official NPI Registry.