Kristen Bordelon Jeansonne, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP09522 Issued in LA

Practice address

1007 Sycamore St Ste B
Cottonport, LA 71327-3403

Phone

(800) 462-0742

Fax

(318) 964-2554

NPI assigned

Jul 25, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kristen Michelle Bordelon Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 38)

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CEDCAA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cenla Family Medicine Associates, LLC

  • Family Medicine Physician
  • Alexandria, LA
  • NPI 1538397542

  Nurse Practitioner

  Medicare reassignment NPD
• Winn Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Winnfield, LA
  • NPI 1275769119
  Medicare reassignment NPD
• Winn Community Health Center, Inc.

  dba Cypress Springs ESBC

  • Federally Qualified Health Center (FQHC)
  • Ruston, LA
  • NPI 1447133459
  NPD
• Winn Community Health Center, Inc.

  dba Bienville Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Ringgold, LA
  • NPI 1962882191
  NPD
• Winn Community Health Center, Inc.

  dba L.S. Rugg Elementary School Based Clinic

  • Federally Qualified Health Center (FQHC)
  • Alexandria, LA
  • NPI 1134741077
  NPD (past)
• Winn Community Health Center, Inc.

  dba Alexandria Middle Magnet School-Based Clinic

  • Federally Qualified Health Center (FQHC)
  • Alexandria, LA
  • NPI 1396267068

  Family

  NPD (past)
• Winn Community Health Center, Inc.

  dba Pineville High School Based Clinic

  • Federally Qualified Health Center (FQHC)
  • Pineville, LA
  • NPI 1497377337
  NPD (past)
• Winn Community Health Center, Inc.

  dba Winnfield Senior High School-Based Clinic

  • Federally Qualified Health Center (FQHC)
  • Winnfield, LA
  • NPI 1689154387

  Family

  NPD (past)
• Winn Community Health Center, Inc.

  dba Arthur F. Smith Middle Magnet School Based Clinic

  • Federally Qualified Health Center (FQHC)
  • Alexandria, LA
  • NPI 1790307635
  NPD (past)

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1831612415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 SYCAMORE ST STE B",
            "city": "COTTONPORT",
            "state": "LA",
            "postal_code": "713273403",
            "telephone_number": "800-462-0742",
            "fax_number": "318-964-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 SYCAMORE ST STE B",
            "city": "COTTONPORT",
            "state": "LA",
            "postal_code": "713273403",
            "telephone_number": "800-462-0742",
            "fax_number": "318-964-2554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1007 Sycamore St Ste B",
            "address_purpose": "LOCATION",
            "city": "Cottonport",
            "state": "LA",
            "postal_code": "713273403",
            "country_code": "US",
            "telephone_number": "800-462-0742 x150",
            "fax_number": "318-717-1663",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1007 Sycamore St Ste B",
            "address_purpose": "LOCATION",
            "city": "Cottonport",
            "state": "LA",
            "postal_code": "713273403",
            "country_code": "US",
            "telephone_number": "800-462-0742 x150",
            "fax_number": "318-717-1663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORDELON JEANSONNE",
        "first_name": "KRISTEN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP09522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "BORDELON",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• A B C Transport Service L.L.C.
• Lasandra Augustine
• Avoyelles Women's Healthcare, LLC
• Dustin Borrel, LMSW
• Jeanne Cancienne, SOCIAL WORKER, LMSW
• CLHG-Avoyelles LLC (Cottonport Family Care Center)
• Cottonport Corner Drug LLC
• Eddie's Pharmacy, Inc.

• Family Nurse Practitioner in Cottonport, LA
• Providers in Cottonport, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.