Individual provider Active NPI

Zachary Backstrom

  • Student in an Organized Health Care Education/Training Program
  • Jefferson, LA
National Provider Identifier
1891586475
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1401 A Jefferson Highway
Academic Center, 1St Floor
Jefferson, LA 70121
Phone
(504) 842-3260
Fax
(504) 842-3193
NPI assigned
May 14, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250624002705 LA Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 9032621172

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1401 A Jefferson Highway
Academic Center, 1St Floor
Jefferson, LA 70121

Mailing address

2215 40TH St NW Apt 2
Washington, DC 20007-1731

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 14, 2025.

{
    "created_epoch": "1747180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1891586475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 40TH ST NW APT 2",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200071731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 A JEFFERSON HIGHWAY",
            "address_2": "ACADEMIC CENTER, 1ST FLOOR",
            "city": "JEFFERSON",
            "state": "LA",
            "postal_code": "70121",
            "telephone_number": "504-842-3260",
            "fax_number": "504-842-3193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKSTROM",
        "first_name": "ZACHARY",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-05-14",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, LA

Sources for this page

Verify at the official NPI Registry.