Individual provider Active NPI

Jessica Ikhanosa Abhulimhen, MD

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1639665136
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
343771 Issued in LA
Practice address
6431 Fannin St
Houston, TX 77030-1501
Phone
(713) 500-6526
NPI assigned
Jul 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 343771 LA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

6431 Fannin St
Houston, TX 77030-1501

Mailing address

6431 Fannin St
Houston, TX 77030-1501

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240917004809 LA Practitioner - Internal Medicine 0446653554 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Louisiana Physicians, LLCGroup PAC ID 7315396355, 17 clinicians

Practice addresses (Care Compare)

524 Doctor Michael Debakey Dr
Lake Charles, LA 70601-5725
Phone (337) 436-2511

Hospital & facility affiliations

  • Christus Ochsner St Patrick Hospital Hospital, Lake Charles, LA, CCN 190027
  • Byrd Regional Hospital Hospital, Leesville, LA, CCN 190164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
343771LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Louisiana Physicians, LLC Internal Medicine CurrentSince Sep 9, 2024 Accepting new patients
Central Louisiana Physicians, LLC Internal Medicine CurrentSince Sep 9, 2024 Accepting new patients
Northeast Louisiana Physicians, LLC Internal Medicine CurrentSince Sep 9, 2024 Accepting new patients
Christus Health Southwestern Louisiana Past Accepting new patients

Locations

3330 Masonic Dr
Alexandria, LA 71301
Phone (318) 448-6917

2531 Viking Dr
Bossier City, LA 71111
Phone (318) 681-7000

200 Corporate Blvd
Lafayette, LA 70508

524 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 430-4455

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1531008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1639665136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-6526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABHULIMHEN",
        "first_name": "JESSICA",
        "middle_name": "IKHANOSA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-08",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "343771",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.