Jacquelyn Kibodeaux White, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

021607 Issued in LA

Practice address

4001 Ridgemont St
Ruston, LA 71270-9596

Phone

(318) 251-8838

NPI assigned

Aug 28, 2006

Last updated

May 8, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Louisiana State University School of Medicine in Shreveport, 1988

Medicare assignment

May accept Medicare assignment

Group practices

Ward 3 4 and 10 Hospital Service District of Parish of UnionGroup PAC ID 8123011137, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Reeves Memorial Medical Center Hospital, Bernice, LA, CCN 191326
• Reeves Memorial Medical Center Nursing home, CCN 19Z326

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CGIECA

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.

• Ward 3 4 & 10 Hospital Service District of Parish of Union

  dba Reeves Memorial Medical Center

  • Family Medicine Physician
  • Bernice, LA
  • NPI 1124277728
  Medicare reassignment Care Compare group NPD
• Ed Physicians of West Louisiana, LLC

  • Emergency Medicine Physician
  • West Monroe, LA
  • NPI 1255460143
  Medicare reassignment NPD
• Louisiana Department of Health - Office of Public Health

  dba Child Spec Health Services

  • Public Health or Welfare Agency
  • New Orleans, LA
  • NPI 1144372343
  Medicare reassignment NPD
• Northern Louisiana Emergency Physicians, LLP

  dba Northern Louisiana Physicians LLP

  • Emergency Medicine Physician
  • Ruston, LA
  • NPI 1588828172
  Medicare reassignment NPD
• Louisiana Department of Health - Office of Public Health

  dba Office of Public Health

  • Public Health or Welfare Agency
  • Baton Rouge, LA
  • NPI 1396316212
  NPD
• Louisiana Department of Health - Office of Public Health

  • Public Health or Welfare Agency
  • New Orleans, LA
  • NPI 1649355561
  NPD
• Northern Louisiana Emergency Physicians LLP

  dba Northern Louisiana Physicians LLP

  • Emergency Medicine Physician
  • Winnfield, LA
  • NPI 1497085690
  NPD
• LGH Oncology Clinic

  • Hematology & Oncology Physician
  • Ruston, LA
  • NPI 1225133622
  NPD (past)
• LTP Medical Mobile, Inc.

  dba The Health Hut

  • Family Medicine Physician
  • Ruston, LA
  • NPI 1649564824
  NPD (past)
• Premier Family Clinic

  • Family Nurse Practitioner
  • Minden, LA
  • NPI 1003469479
  NPD (past)

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

• Ward 3 4 & 10 Hospital Service District of Parish of Union

  dba Reeves Memorial Medical Center

  • Critical Access Hospital
  • Bernice, LA
  • NPI 1023018835
  Care Compare affiliation
• Ward 3 4 & 10 Hospital Service District of Parish of Union

  dba Reeves Memorial Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Bernice, LA
  • NPI 1447465075

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1629186812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 RIDGEMONT ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712709596",
            "telephone_number": "318-251-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 RIDGEMONT ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712709596",
            "telephone_number": "318-251-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JACQUELYN",
        "middle_name": "KIBODEAUX",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "LA201607",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "021607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1121991",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Lanson Wheeler, PH.D.
• Justin Wheeler, MS, ATC, LAT, CSCS
• Payton Barrett Whiddon, MD
• Allen Whitaker
• Elizabeth White, PT, DPT
• Welton Miguel Wiley, LAC, CCS
• Dennis Wilford
• Korick Wilkerson
• Lovely Wilkerson, DPT
• Catherine Williams-Fortenberry

• Emergency Medicine Physician in Ruston, LA
• Providers in Ruston, LA by specialty
• Emergency Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.