Individual provider Active NPI

Joni Ferguson Nickens, NP

  • Family Nurse Practitioner
  • Baton Rouge, LA
National Provider Identifier
1831196096
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN062230AP03515 Issued in LA
Practice address
4560 North Blvd
Ste 101
Baton Rouge, LA 70806-4043
Phone
(225) 341-5901
Fax
(225) 341-5903
NPI assigned
Jul 3, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

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 RN062230AP03515 LA Primary

Addresses

Primary practice location

4560 North Blvd
Ste 101
Baton Rouge, LA 70806-4043

Mailing address

42076 Highway 933
Prairieville, LA 70769-6106
Phone (225) 622-2048

Other identifiers 1

IdentifierTypeStateIssuer
1170763MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN062230AP03515LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health of Louisiana, LLC PastSince Mar 31, 2014 Accepting new patients
Family Health of St. Helena, LLC Past Accepting new patients

Organizations & group practices 2

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": "1120348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1831196096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42076 HIGHWAY 933",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707696106",
            "telephone_number": "225-622-2048",
            "fax_number": "225-319-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 NORTH BLVD",
            "address_2": "STE 101",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708064043",
            "telephone_number": "225-341-5901",
            "fax_number": "225-341-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKENS",
        "first_name": "JONI",
        "middle_name": "FERGUSON",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-03",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "RN062230AP03515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1170763",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.