Individual provider Active NPI

Jerelyn Carpenter

  • Medical-Surgical Registered Nurse
  • Pineville, LA
National Provider Identifier
1609390327
Registry record updated Aug 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
123733 Issued in LA
Practice address
2495 Shreveport Hwy
Pineville, LA 71360-4044
Phone
(318) 473-0010
NPI assigned
Aug 3, 2017
Last updated
Aug 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 123733 LA Primary

Addresses

Primary practice location

2495 Shreveport Hwy
Pineville, LA 71360-4044

Mailing address

1920 Brentwood Ave
Alexandria, LA 71301-3801
Phone (337) 424-3253

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

LicenseStateTypeSpecialty
123733LAMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501718400000",
    "number": "1609390327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 BRENTWOOD AVE",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013801",
            "telephone_number": "337-424-3253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 SHREVEPORT HWY",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604044",
            "telephone_number": "318-473-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "JERELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2017-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "LA",
            "license": "123733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pineville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2017; 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.