Organization Active NPI

Marjorie Louis-Jacques NP Family Health PC

  • Nurse Practitioner
  • Wading River, NY
National Provider Identifier
1730828187
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MARJORIE LOUIS-JACQUES NP FAMILY HEALTH PC
Practice address
6144 Route 25a Ste 18B
Wading River, NY 11792-2018
Phone
(732) 239-0155
NPI assigned
Jun 2, 2022
Last updated
Jun 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Authorized official

Name
Marjorie Louis-Jacques, NPNPI 1770895906
Title
Authorized Official
Phone
(732) 239-0115

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
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

6144 Route 25a Ste 18B
Wading River, NY 11792-2018

Mailing address

6144 Route 25a Ste 18B
Wading River, NY 11792-2018

Other identifiers 1

IdentifierTypeStateIssuer
339159OtherNYLICENSE

National Provider Directory

National Provider Directory

Locations

6144 Route 25A
Ste 18B
Wading River, NY 11792
Phone (732) 239-0155

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1730828187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6144 ROUTE 25A STE 18B",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6144 ROUTE 25A STE 18B",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922018",
            "telephone_number": "732-239-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARJORIE LOUIS-JACQUES NP FAMILY HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "LOUIS-JACQUES",
        "authorized_official_first_name": "MARJORIE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "732-239-0115",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "339159",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wading River, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.