Active NPI
Jebadiah Cormier, DC
- Chiropractor
- Mamou, LA
National Provider Identifier
1851772040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1830
- Practice address
- 704 Poinciana Ave Ste C
Mamou, LA 70554-2224 - Phone
- (337) 468-3337
- Fax
- (337) 468-3422
- NPI assigned
- Jun 12, 2015
- Last updated
- Aug 12, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 12921 | TX | |
| Chiropractor | 111N00000X | 1830 | LA | Primary |
Addresses
Primary practice location
704 Poinciana Ave Ste C
Mamou, LA 70554-2224
Mailing address
704 Poinciana Ave Ste C
Mamou, LA 70554-2224
Phone (337) 468-3337
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12921 | TX | MD | Addiction (Substance Use Disorder) Counselor |
| 1830 | LA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597190400000",
"number": "1851772040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "704 POINCIANA AVE STE C",
"city": "MAMOU",
"state": "LA",
"postal_code": "705542224",
"telephone_number": "337-468-3337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "704 POINCIANA AVE STE C",
"city": "MAMOU",
"state": "LA",
"postal_code": "705542224",
"telephone_number": "337-468-3337",
"fax_number": "337-468-3422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORMIER",
"first_name": "JEBADIAH",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-12",
"last_updated": "2020-08-12",
"certification_date": "2020-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "12921",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "LA",
"license": "1830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mamou, LA
- Christopher Cutter MD Inc a Professional Medical Corportation
- Richard C. Clarke, MD
- Compass Behavioral Center LLC
- Cora Manuel Therapy Services, LLC (Active Physical Rehab)
- Alaina Coreil, APRN-PMHNP
- Rebecca Reed Cormier, PHARM.D.
- Haley Monette Deshotel, O.T.
- Katie Brooke Deshotel, APRN WHNP
- Rainee R Deshotel, SLP
- Robin Mark Deshotel, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.