NPIMap

Organization Active NPI

JWM Renal, LLC

  • Nephrology Physician
  • Covington, LA
National Provider Identifier
1790665396
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
JWM RENAL, LLC
Practice address
1970 N Highway 190
Covington, LA 70433-5364
Phone
(985) 867-8585
Fax
(985) 867-3644
NPI assigned
Sep 4, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Authorized official

Name
Jon W Mares, DONPI 1023375300
Title
Provider / Owner
Phone
(985) 256-5599

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
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

1970 N Highway 190
Covington, LA 70433-5364

Mailing address

PO Box 3370
Covington, LA 70434-3370
Phone (985) 867-8585

Other practice location 1

1415 Avenue F
Bogalusa, LA 70427-4340
Phone (985) 867-8585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251028000254 LA Part B Supplier - Clinic/Group Practice 0345739702 Receives reassigned benefits from 2 practitioners
Practice locations: Covington, LA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1756944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761004800000",
    "number": "1790665396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3370",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704343370",
            "telephone_number": "985-867-8585",
            "fax_number": "985-867-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 N HIGHWAY 190",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704335364",
            "telephone_number": "985-867-8585",
            "fax_number": "985-867-3644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 Avenue F",
            "address_purpose": "LOCATION",
            "city": "Bogalusa",
            "state": "LA",
            "postal_code": "704274340",
            "country_code": "US",
            "telephone_number": "985-867-8585",
            "fax_number": "985-867-3644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JWM RENAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A",
        "authorized_official_last_name": "MARES",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PROVIDER / OWNER",
        "authorized_official_telephone_number": "985-256-5599",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.