Ambrosia A Jeffery, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A004788 Issued in AR

Practice address

1666 E Bert Koun Loop Ste 105
Shreveport, LA 71105-5718

Phone

(318) 212-3520

Fax

(318) 212-3525

NPI assigned

Aug 24, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ambrosia Caruso Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AR, LA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

WK Urgent Care Center-PierremontGroup PAC ID 8123016946, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• WK Urgent Care Center-Pierremont

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1639115132
  Medicare reassignment Care Compare group NPD
• Brfhh Monroe LLC

  • Internal Medicine Physician
  • Monroe, LA
  • NPI 1811324882
  Medicare reassignment NPD
• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222
  Medicare reassignment NPD
• University Health Shreveport LLC

  • Nurse Practitioner
  • Shreveport, LA
  • NPI 1619443611
  Medicare reassignment NPD
• Ess of El Dorado, LLC

  • Emergency Medicine Physician
  • El Dorado, AR
  • NPI 1861851131
  Medicare reassignment NPD
• Sama Healthcare Services, PA

  • Primary Care Clinic/Center
  • El Dorado, AR
  • NPI 1235290735
  Medicare reassignment NPD
• South Arkansas Emergency Physicians LLP

  • Emergency Medicine Physician
  • El Dorado, AR
  • NPI 1942435458
  Medicare reassignment NPD
• Brfhh Monroe LLC

  • Psychiatric Hospital Unit
  • Monroe, LA
  • NPI 1255761151
  NPD
• University Health Shreveport LLC

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
  • NPI 1629544622
  NPD
• South Arkansas Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Siloam Springs, AR
  • NPI 1225452055
  NPD
• WK Advanced Surgery Center

  • Surgery Physician
  • Shreveport, LA
  • NPI 1609110634
  NPD (past)
• WK Urgent Care Center - Bossier

  • Family Medicine Physician
  • Bossier City, LA
  • NPI 1982640884
  NPD (past)

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1740735323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1666 E BERT KOUN LOOP STE 105",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055718",
            "telephone_number": "318-212-3520",
            "fax_number": "318-212-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1666 E BERT KOUN LOOP STE 105",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055718",
            "telephone_number": "318-212-3520",
            "fax_number": "318-212-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERY",
        "first_name": "AMBROSIA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-24",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A004788",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.mettles.com",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMBROSIA",
            "last_name": "CARUSO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kendra C Jefferson
• Maurice Jamal Jefferson Sr.
• Sharon Denise Jefferson, MSW
• Tongala Renee Jefferson
• Willie Jefferson, MA
• Jeffrey Kerst DDS LLC
• Jeffrey Lee Martin, DMD a Professional Dental Corp.
• Jeffrey M Gosslee MD Apmc
• Shawndreka Jelks
• Brittany M Jellum, PTA

• Family Nurse Practitioner in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.