Active NPI
Jonathan Lamont Mixon
- Psychiatric/Mental Health Nurse Practitioner
- Lafayette, LA
National Provider Identifier
1508260720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- AP08044
- Practice address
- 106 Heymann Blvd
Lafayette, LA 70503-2322 - Phone
- (337) 504-4279
- NPI assigned
- Oct 17, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP08044 | LA | Primary |
Addresses
Primary practice location
106 Heymann Blvd
Lafayette, LA 70503-2322
Mailing address
1713 Pembroke St
New Iberia, LA 70563-8616
Phone (337) 380-9064
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP08044 | LA | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421020800000",
"number": "1508260720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1713 PEMBROKE ST",
"city": "NEW IBERIA",
"state": "LA",
"postal_code": "705638616",
"telephone_number": "337-380-9064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 HEYMANN BLVD",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705032322",
"telephone_number": "337-504-4279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIXON",
"first_name": "JONATHAN",
"middle_name": "LAMONT",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-10-17",
"last_updated": "2015-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "LA",
"license": "AP08044",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.