Jeremy Claiborne, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

204692 Issued in LA

Practice address

510 E. Stoner Avenue
Overton Brooks VA Medical Center
Shreveport, LA 71101

Phone

(318) 990-5000

NPI assigned

May 14, 2008

Last updated

Mar 11, 2024By the provider in NPPES

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/3c975af8-28ae-4d97-adec-66228015b5a8/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Niagara Falls Memorial Medical Center

  • General Acute Care Hospital
  • Niagara Falls, NY
  • NPI 1285717298
  Medicare reassignment NPD
• Niagara Falls Memorial Medical Center

  • Obstetrics & Gynecology Physician
  • Niagara Falls, NY
  • NPI 1982659256
  Medicare reassignment NPD
• Niagara Falls Memorial Medical Center

  • Oncology Clinic/Center
  • Niagara Falls, NY
  • NPI 1144842816
  NPD
• Bayou Healthcare, LLC

  dba Crossroads Regional Hospital

  • Psychiatric Hospital
  • Alexandria, LA
  • NPI 1083898571

  Psychiatry

  NPD (past)
• Cognitive Institute Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mansfield, LA
  • NPI 1790829646
  NPD (past)

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1609043017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 E STONER AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014243",
            "telephone_number": "870-779-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E. STONER AVENUE",
            "address_2": "OVERTON BROOKS VA MEDICAL CENTER",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71101",
            "telephone_number": "318-990-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAIBORNE",
        "first_name": "JEREMY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-14",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "204692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS MEDICAID",
            "identifier": "01733393",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053732",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "4R117",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01158547",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• City Pain Management PLLC
• City Too City Transportation LLC
• CJMG Holdings, LLC (Ortho One)
• Claiborne and Mansfield LLC (Roseview Nursing & Rehabilitation Center)
• Alvin Claiborne Jr.
• Nikeya D Claiborne, PMHNP
• Robert Clanton, PH.D.
• Clarence Teagle MD and Willis-Knighton Medical Center
• Joni Claridy
• Kim Clark-Green

• Psychiatry Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Psychiatry Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.