Deion A Jack

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

2204 St. Charles St
Lecompte, LA 71346

Phone

(318) 406-3044

Fax

(318) 406-3045

NPI assigned

Apr 14, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1770017931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 ST. CHARLES ST",
            "city": "LECOMPTE",
            "state": "LA",
            "postal_code": "71346",
            "telephone_number": "318-406-3044",
            "fax_number": "318-406-3045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 ST. CHARLES ST",
            "city": "LECOMPTE",
            "state": "LA",
            "postal_code": "71346",
            "telephone_number": "318-406-3044",
            "fax_number": "318-406-3045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACK",
        "first_name": "DEION",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-14",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Lecompte, LA
• Providers in Lecompte, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; 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.