Individual provider Active NPI

Myles Landon Jaynes, D.O.

  • Family Medicine Physician
  • Baton Rouge, LA
National Provider Identifier
1730420167
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO000390 Issued in LA
Practice address
12525 Perkins Rd
Suite a
Baton Rouge, LA 70810-1907
Phone
(225) 761-4256
Fax
(225) 761-4034
NPI assigned
Mar 11, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X BPI-0040681 TX
Family Medicine Physician 207Q00000X DO000390 LA Primary

Addresses

Primary practice location

12525 Perkins Rd
Suite a
Baton Rouge, LA 70810-1907

Mailing address

12525 Perkins Rd
Suite a
Baton Rouge, LA 70810-1907
Phone (225) 761-4256

Other identifiers 1

IdentifierTypeStateIssuer
P1-0040681OtherTXPIT

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other
Direct Messaging Address mjaynes9176@direct.casso.us.com Direct

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
I20141114001950 LA Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 0042432635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Our Lady of the Lake Physician Group LLCGroup PAC ID 4587849781, 637 clinicians

Practice addresses (Care Compare)

12525 Perkins Rd a
Baton Rouge, LA 70810-1907
Phone (225) 765-4256

Hospital & facility affiliations

  • Pinnacle Home Health of Baton Rouge Home health agency, Baton Rouge, LA, CCN 197770
  • Our Lady of the Lake Regional Medical Center Hospital, Baton Rouge, LA, CCN 190064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO000390LAMDFamily Medicine Physician
BPI-0040681TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Oct 1, 2014 Accepting new patients
Our Lady of the Lake Physician Group LLC Family Medicine CurrentSince Oct 1, 2014 Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients

Locations

12525 Perkins Rd
#A
Baton Rouge, LA 70810
Phone (225) 761-4256

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

Interoperability endpoints

  • Direct secure messaging: mjaynes9176@direct.casso.us.com

Organizations & group practices 3

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 2

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": "1362960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1730420167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12525 PERKINS RD",
            "address_2": "SUITE A",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708101907",
            "telephone_number": "225-761-4256",
            "fax_number": "225-761-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12525 PERKINS RD",
            "address_2": "SUITE A",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708101907",
            "telephone_number": "225-761-4256",
            "fax_number": "225-761-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYNES",
        "first_name": "MYLES",
        "middle_name": "LANDON",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-11",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BPI-0040681",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "DO000390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIT",
            "identifier": "P1-0040681",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "12525 Perkins Rd",
            "address_2": "Suite A",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708101907",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjaynes9176@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mjaynes9176@direct.casso.us.com",
            "address_1": "12525 Perkins Rd",
            "address_2": "Suite A",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708101907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.