Charlene Jacobs

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Practice address

320 Williams Blvd
Kenner, LA 70062-7630

Phone

(504) 416-1840

NPI assigned

May 16, 2022

Last updated

Dec 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1538806179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 KINLER ST",
            "city": "LULING",
            "state": "LA",
            "postal_code": "700704533",
            "telephone_number": "504-416-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 WILLIAMS BLVD",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700627630",
            "telephone_number": "504-416-1840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 Chateau Blvd",
            "address_purpose": "LOCATION",
            "city": "Kenner",
            "state": "LA",
            "postal_code": "700652734",
            "country_code": "US",
            "telephone_number": "504-416-1840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "CHARLENE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-16",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "LA",
            "license": "441590119",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Kenner, LA
• Providers in Kenner, LA by specialty
• Durable Medical Equipment & Medical Supplies in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.