Individual provider Active NPI

Jennifer Ashley Wainwright, APRN, FNP-C

  • Family Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1609120211
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP06939 Issued in LA
Practice address
2770 3Rd Ave Ste 350
Lake Charles, LA 70601-0404
Phone
(337) 494-2750
Fax
(337) 494-2760
NPI assigned
Nov 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Health Clinical Nurse Specialist 364SF0001X AP06939 LA
Family Nurse Practitioner 363LF0000X AP06939 LA Primary

Addresses

Primary practice location

2770 3Rd Ave Ste 350
Lake Charles, LA 70601-0404

Mailing address

PO Box 122309 Dept 2309
Dallas, TX 75312-2309
Phone (337) 494-2921

Other identifiers 2

IdentifierTypeStateIssuer
AP06939OtherLASTATE NP LICENSE
2336819MedicaidLA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20131024000834 LA Practitioner - Nurse Practitioner 6709011927 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LCMS Pulmonary Associates of Southwest LouisianaGroup PAC ID 0446439939, 9 clinicians

Practice addresses (Care Compare)

2770 3Rd Ave
Suite 350
Lake Charles, LA 70601-0404
Phone (337) 494-2750

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP06939LAMDFamily Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
LCMS Pulmonary Associates of Southwest Louisiana CurrentSince Jan 1, 2015 Accepting new patients
Lake Charles Medical Services Inc Past Accepting new patients

Locations

2770 3rd Ave
Ste 350
Lake Charles, LA 70601
Phone (337) 494-2750

1701 Oak Park Blvd
Lake Charles, LA 70601
Phone (337) 494-3000

2770 3rd Ave
Lake Charles, LA 70601
Phone (337) 494-2674

Interoperability endpoints

  • Direct secure messaging: jwainwright5282011@direct.casso.us.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1609120211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122309 DEPT 2309",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753122309",
            "telephone_number": "337-494-2921",
            "fax_number": "337-494-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 3RD AVE STE 350",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706010404",
            "telephone_number": "337-494-2750",
            "fax_number": "337-494-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAINWRIGHT",
        "first_name": "JENNIFER",
        "middle_name": "ASHLEY",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-05",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "LA",
            "license": "AP06939",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP06939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE NP LICENSE",
            "identifier": "AP06939",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2336819",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.