Individual provider Active NPI

Jennie Lynn Dedon, NP

  • Family Nurse Practitioner
  • Baton Rouge, LA
National Provider Identifier
1699019653
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP06959 Issued in LA
Practice address
3600 Florida Blvd
Baton Rouge, LA 70806-3842
Phone
(225) 767-4673
NPI assigned
Nov 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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 AP06959 LA Primary

Addresses

Primary practice location

3600 Florida Blvd
Baton Rouge, LA 70806-3842

Mailing address

3600 Florida Blvd
Baton Rouge, LA 70806-3842
Phone (225) 767-4673

Other identifiers 1

IdentifierTypeStateIssuer
2346865MedicaidLA

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
I20140425001321 LA Practitioner - Nurse Practitioner 5799918835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospice Foundation of Greater Baton RougeGroup PAC ID 8022040229, 2 clinicians

Practice addresses (Care Compare)

3600 Florida St
Baton Rouge, LA 70806-3842
Phone (225) 767-4673

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP06959LAMDFamily Nurse Practitioner

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1699019653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 FLORIDA BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708063842",
            "telephone_number": "225-767-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 FLORIDA BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708063842",
            "telephone_number": "225-767-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDON",
        "first_name": "JENNIE",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP06959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2346865",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.