Organization Active NPI

JDB Enterprises LLC

  • Wound Care Registered Nurse
  • Jonesville, LA
National Provider Identifier
1720896756
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Wound Care Registered NurseTaxonomy code 163WW0000X
Legal business name
JDB ENTERPRISES LLC
Practice address
1305 Fourth St Ste B
Jonesville, LA 71343-2123
Phone
(318) 657-4555
Fax
(318) 312-5325
NPI assigned
Dec 23, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Authorized official

Name
Lauren King, FNP-CNPI 1154761351
Title
Ceo
Phone
(318) 758-1529

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WW0000X Primary

Addresses

Primary practice location

1305 Fourth St Ste B
Jonesville, LA 71343-2123

Mailing address

2905 Cameron St Ste B
Monroe, LA 71201-3791
Phone (318) 657-4555

Other names 1

  • DELTA DERM Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250207000889 LA Part B Supplier - Clinic/Group Practice 6103356027 Receives reassigned benefits from 1 practitioner
Practice locations: Jonesville, LA

National Provider Directory

National Provider Directory

Locations

1305 Fourth St
Ste B
Jonesville, LA 71343
Phone (318) 541-6935

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1734912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1720896756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 CAMERON ST STE B",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013791",
            "telephone_number": "318-657-4555",
            "fax_number": "318-312-5325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 FOURTH ST STE B",
            "city": "JONESVILLE",
            "state": "LA",
            "postal_code": "713432123",
            "telephone_number": "318-657-4555",
            "fax_number": "318-312-5325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JDB ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-23",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-22",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-758-1529",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DELTA DERM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jonesville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.