Jacques Jean, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5007327 Issued in NC

Practice address

615 E 6TH St
Ste 106
Charlotte, NC 28202-2918

Phone

(704) 453-1444

Fax

(704) 260-0037

NPI assigned

Sep 24, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508371200000",
    "number": "1477955284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5226 FIREBRICK LN SW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280258807",
            "telephone_number": "704-260-0037",
            "fax_number": "704-260-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E 6TH ST",
            "address_2": "STE 106",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022918",
            "telephone_number": "704-453-1444",
            "fax_number": "704-260-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN",
        "first_name": "JACQUES",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-24",
        "last_updated": "2017-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5007327",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F0814732",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477955284",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• JD Wellness, LLC
• Jdi Life Skills
• Michael Robert Jean-Baptiste, DPT
• Sheena Jean-Jumeau
• Elizabeth Ashley Jean, PHD
• Kashale Hanna Lee Jean
• Lauren Alexis Jeck, MD
• Tommy Lamar Jeffcoat, LCASA
• Valencia H Jeffcoat, FNP
• Meredith Jefferies

• Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.