Jenna Van, MSN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP09009 Issued in LA

Practice address

506 Rock Hollow Dr
Shreveport, LA 71115-2502

Phone

(318) 470-0447

NPI assigned

Aug 22, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

KCC Infusion, LLCGroup PAC ID 4688076896, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• KCC Infusion, LLC

  dba Shreveport Infusion Center

  • Infusion Therapy Clinic/Center
  • Shreveport, LA
  • NPI 1225794506
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1497200257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 ROCK HOLLOW DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152502",
            "telephone_number": "318-470-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 ROCK HOLLOW DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152502",
            "telephone_number": "318-470-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN",
        "first_name": "JENNA",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-22",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP09009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harold J Vallot Jr., CRNA
• Van Associates Nephrology LLC
• Amanda Van Dyke, MOT, OTR/L
• Carter Van Horn
• Chuong Van, PHARM D
• Louis Jacob Vanasselberg, MS, LPC, NCC
• Christopher Vance
• Hannah Brooks Vance, APRN
• Jessica Nicole Vance
• Johnny Vance

• Family Nurse Practitioner in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.