Individual provider Active NPI

Jennifer M Brown, PA-C

  • Physician Assistant
  • Shreveport, LA
National Provider Identifier
1851768642
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.200876 Issued in LA
Practice address
1800 E 70TH St
Shreveport, LA 71105-5302
Phone
(318) 631-9121
Fax
(318) 213-6246
NPI assigned
Aug 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.200876 LA Primary

Addresses

Primary practice location

1800 E 70TH St
Shreveport, LA 71105-5302

Mailing address

3217 Mabel St
Shreveport, LA 71103-4022
Phone (318) 631-9121

Other identifiers 2

IdentifierTypeStateIssuer
2402188MedicaidLA
PA.200876OtherLALICENSE

Other names 1

  • Jennifer Morgan Madole Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151102002751 LA Practitioner - Physician Assistant 0749590891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastrointestinal Specialists AMCGroup PAC ID 0547245086, 32 clinicians

Practice addresses (Care Compare)

1800 E 70TH St
Shreveport, LA 71105-5302
Phone (318) 631-9121

8001 Youree Dr
Shreveport, LA 71115-2302
Phone (318) 212-3200

8001 Youree Dr
Suite 540
Shreveport, LA 71115-2343
Phone (318) 631-9121

Merit-based Incentive Payment System (MIPS)

Final score
88.49 of 100Reported as group
Quality
85.05
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.200876LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Capitol City Family Health Center Incorporated 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": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1851768642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217 MABEL ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034022",
            "telephone_number": "318-631-9121",
            "fax_number": "318-631-9126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E 70TH ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055302",
            "telephone_number": "318-631-9121",
            "fax_number": "318-213-6246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-27",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2402188",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA.200876",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MADOLE",
            "middle_name": "MORGAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.