Jared R Whitehead, A.P.R.N.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP06501 Issued in LA

Practice address

1727 Imperial Blvd
BLDG 2
Lake Charles, LA 70605-5362

Phone

(337) 310-3670

Fax

(337) 421-1443

NPI assigned

Jul 14, 2011

Sex

Male

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heinen Medical Clinics LLCGroup PAC ID 9739422304, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Acadian Medical Center Hospital, Eunice, LA, CCN 190318

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.

• Heinen Medical Clinics LLC

  • Rural Health Clinic/Center
  • Eunice, LA
  • NPI 1124593900
  Medicare reassignment Care Compare group NPD
• Heinen Medical Clinics LLC

  • Rural Health Clinic/Center
  • Kinder, LA
  • NPI 1841928660
  NPD
• Heinen Medical Clinics LLC

  • Rural Health Clinic/Center
  • Ville Platte, LA
  • NPI 1871073304
  NPD
• Heinen Medical VP LLC

  • Family Medicine Physician
  • Ville Platte, LA
  • NPI 1043721624
  NPD (past)
• Imperial Health LLP

  • Family Medicine Physician
  • Lake Charles, LA
  • NPI 1326396375
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• CLHG-Acadian, LLC

  • General Acute Care Hospital
  • Eunice, LA
  • NPI 1396394961
  Care Compare affiliation

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1528356367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 DR MICHAEL DEBAKEY DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015724",
            "telephone_number": "337-312-8258",
            "fax_number": "337-312-6708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 IMPERIAL BLVD",
            "address_2": "BLDG 2",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055362",
            "telephone_number": "337-310-3670",
            "fax_number": "337-421-1443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "JARED",
        "middle_name": "R",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-14",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "LA",
            "license": "AP06501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kia White
• Laura Marie White, OTR
• Melanie Bousegard White, FNP
• Rachel White
• Sarah Schultz White, BCBA
• Jerry L Whiteman, PHD.
• Charlissa Whitted, LPN
• Alexandra Widcamp - Feagin, DPT
• Regan Z Wild
• Errol P. Wilder, M.D.

• Adult Health Nurse Practitioner in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Adult Health Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.
• 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.