Active NPI
Jane Temitope Fadesere, PHARM.D
- Pharmacist
- Metairie, LA
National Provider Identifier
1629352539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18643
- Practice address
- 3535 Severn Ave
Metairie, LA 70002-3482 - Phone
- (504) 456-4851
- NPI assigned
- Oct 11, 2011
- Last updated
- Oct 11, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18643 | LA | Primary |
| Pharmacist | 183500000X | 47232 | TX | |
| Pharmacist | 183500000X | 17798 | MD |
Addresses
Primary practice location
3535 Severn Ave
Metairie, LA 70002-3482
Mailing address
5300 Veterans Blvd
Metairie, LA 70003-1726
Phone (504) 456-4851
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18643 | LA | MD | Pharmacist |
| 17798 | MD | MD | Pharmacist |
| 47232 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Louisiana CVS Pharmacy LLC | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318291200000",
"number": "1629352539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5300 VETERANS BLVD",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700031726",
"telephone_number": "504-456-4851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3535 SEVERN AVE",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700023482",
"telephone_number": "504-456-4851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FADESERE",
"first_name": "JANE",
"middle_name": "TEMITOPE",
"name_prefix": "Dr.",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-11",
"last_updated": "2011-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "18643",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "47232",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "17798",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Metairie, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.