Active NPI
Demetris Jackson
- Driver
- Kenner, LA
National Provider Identifier
1699342287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- Practice address
- 3406 E Louisiana State Dr
Kenner, LA 70065-2524 - Phone
- (504) 380-2792
- NPI assigned
- Jun 10, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | LA | Primary |
Addresses
Primary practice location
3406 E Louisiana State Dr
Kenner, LA 70065-2524
Mailing address
3406 E Louisiana State Dr
Kenner, LA 70065-2524
Phone (504) 380-2792
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Juanitas Transportation LLC | Current | 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 and National Provider Directory roles.
-
- Non-emergency Medical Transport (VAN)
- Kenner, LA
- NPI 1447827050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623283200000",
"number": "1699342287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3406 E LOUISIANA STATE DR",
"city": "KENNER",
"state": "LA",
"postal_code": "700652524",
"telephone_number": "504-380-2792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3406 E LOUISIANA STATE DR",
"city": "KENNER",
"state": "LA",
"postal_code": "700652524",
"telephone_number": "504-380-2792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DEMETRIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-10",
"last_updated": "2021-06-10",
"certification_date": "2021-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "LA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenner, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.