NPIMap

Organization Active NPI

Jerrilynn J. Primeaux, D.C. (a Professional Chiropractic Corporation)

  • Chiropractor
  • Lafayette, LA
National Provider Identifier
1811213531
Registry record updated Oct 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1504 Issued in LA
Legal business name
JERRILYNN J. PRIMEAUX, D.C. (A PROFESSIONAL CHIROPRACTIC CORPORATION)
Practice address
201 Westmark Blvd
Ste E
Lafayette, LA 70506-7370
Phone
(337) 504-4378
Fax
(337) 534-0041
NPI assigned
Apr 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2015

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

Authorized official

Name
Dr. Jerrilynn J Primeaux, D.C.NPI 1285877753
Title
Chiropractor
Phone
(337) 306-0692

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1504 LA Primary

Addresses

Primary practice location

201 Westmark Blvd
Ste E
Lafayette, LA 70506-7370

Mailing address

PO Box 60082
Lafayette, LA 70596-0082
Phone (337) 504-4378

Other names 1

  • ADVANCED CHIROPRACTIC AND SPORTS REHABILITATION CLINIC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101202001231 LA Part B Supplier - Clinic/Group Practice 6103013123 Receives reassigned benefits from 1 practitioner
Practice locations: Lafayette, LA

National Provider Directory

National Provider Directory

Locations

2425 W Congress St
Lafayette, LA 70506
Phone (337) 371-9312

Practitioners & affiliated clinicians

Practitioners 1

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": "1271721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444003200000",
    "number": "1811213531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60082",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705960082",
            "telephone_number": "337-504-4378",
            "fax_number": "337-534-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 WESTMARK BLVD",
            "address_2": "STE E",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705067370",
            "telephone_number": "337-504-4378",
            "fax_number": "337-534-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRILYNN J. PRIMEAUX, D.C. (A PROFESSIONAL CHIROPRACTIC CORPORATION)",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-20",
        "last_updated": "2015-10-05",
        "status": "A",
        "authorized_official_last_name": "PRIMEAUX",
        "authorized_official_first_name": "JERRILYNN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "337-306-0692",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVANCED CHIROPRACTIC AND SPORTS REHABILITATION CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; 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.