Active NPI
Jacqueline Davis
- Health Educator
- Pearl River, LA
National Provider Identifier
1619805611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- License
- 973416
- Practice address
- 67212 Chris Kennedy Rd
Pearl River, LA 70452-4568 - Phone
- (985) 256-4215
- NPI assigned
- May 11, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | 973416 | LA | Primary |
Addresses
Primary practice location
67212 Chris Kennedy Rd
Pearl River, LA 70452-4568
Mailing address
67212 Chris Kennedy Rd
Pearl River, LA 70452-4568
Phone (985) 256-4215
Other names 1
- Jackie Davis
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
| License | State | Type | Specialty |
|---|---|---|---|
| 973416 | LA | MD | Health Educator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1778457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778457600000",
"number": "1619805611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67212 CHRIS KENNEDY RD",
"city": "PEARL RIVER",
"state": "LA",
"postal_code": "704524568",
"telephone_number": "985-256-4215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67212 CHRIS KENNEDY RD",
"city": "PEARL RIVER",
"state": "LA",
"postal_code": "704524568",
"telephone_number": "985-256-4215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JACQUELINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-05-11",
"last_updated": "2026-05-11",
"certification_date": "2026-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Health Educator",
"state": "LA",
"license": "973416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JACKIE",
"last_name": "DAVIS",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Pearl River, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.