Individual provider Active NPI

Jenny Madere, FNP

  • Family Nurse Practitioner
  • Gonzales, LA
National Provider Identifier
1760724934
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP07208 Issued in LA
Practice address
1125 W Highway 30
Gonzales, LA 70737-5004
Phone
(225) 647-5012
NPI assigned
Mar 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP07208 LA Primary

Addresses

Primary practice location

1125 W Highway 30
Gonzales, LA 70737-5004

Mailing address

PO Box 215
Saint Amant, LA 70774-0215
Phone (225) 558-6064

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130807000501 LA Practitioner - Nurse Practitioner 1557503364 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Emergency Physicians LLC CurrentSince Jul 1, 2013 Accepting new patients

Locations

1125 W Highway 30
Gonzales, LA 70737
Phone (225) 621-2975

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.

NPI Registry JSON

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1760724934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 215",
            "city": "SAINT AMANT",
            "state": "LA",
            "postal_code": "707740215",
            "telephone_number": "225-558-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 W HIGHWAY 30",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707375004",
            "telephone_number": "225-647-5012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADERE",
        "first_name": "JENNY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-26",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP07208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gonzales, LA

Sources for this page

Verify at the official NPI Registry.