Individual provider Active NPI

Jessica Bamburg Sharp, F.N.P.

  • Family Nurse Practitioner
  • West Monroe, LA
National Provider Identifier
1629164280
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APO5017 Issued in LA
Practice address
1117 Cheniere Drew Rd
West Monroe, LA 71291-8551
Phone
(318) 329-4370
Fax
(318) 329-4356
NPI assigned
Oct 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APO5017 LA Primary

Addresses

Primary practice location

1117 Cheniere Drew Rd
West Monroe, LA 71291-8551

Mailing address

183 Gilmore Rd
West Monroe, LA 71292-0174
Phone (318) 396-6005

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
I20070330000004 LA Practitioner - Nurse Practitioner 2466556592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Care Clinic LLCGroup PAC ID 5597812719, 2 clinicians

Practice addresses (Care Compare)

122 Professional Dr
West Monroe, LA 71291-5465
Phone (318) 397-3636

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APO5017LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Clinic LLC CurrentSince Mar 2, 2009 Accepting new patients

Locations

122 Professional Dr
West Monroe, LA 71291
Phone (318) 322-0058

Organizations & group practices 1

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.

Hospital & facility affiliations 8

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629164280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 GILMORE RD",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712920174",
            "telephone_number": "318-396-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 CHENIERE DREW RD",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712918551",
            "telephone_number": "318-329-4370",
            "fax_number": "318-329-4356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP",
        "first_name": "JESSICA",
        "middle_name": "BAMBURG",
        "name_prefix": "Mrs.",
        "credential": "F.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "APO5017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Monroe, LA

Sources for this page

Verify at the official NPI Registry.