Shawna Nikia Jeider, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

146 Issued in LA

Practice address

7777 Hennessy Blvd
Suite 211
Baton Rouge, LA 70808-4300

Phone

(225) 765-7163

Fax

(225) 765-7164

NPI assigned

Oct 20, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Shawna Nikia Verdun Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1891784914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-765-5727",
            "fax_number": "225-765-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD",
            "address_2": "SUITE 211",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084300",
            "telephone_number": "225-765-7163",
            "fax_number": "225-765-7164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8585 Picardy Ave",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708093748",
            "country_code": "US",
            "telephone_number": "225-763-4000",
            "fax_number": "225-763-4039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEIDER",
        "first_name": "SHAWNA",
        "middle_name": "NIKIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-20",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200050",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "200050",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "LA",
            "license": "146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1355615",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWNA",
            "last_name": "VERDUN",
            "middle_name": "NIKIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sharon Jefferson
• Zaquoria D Jefferson
• Jeffrey S. Toler, D.D.S., Millerville Dental Group, a Professional Cor
• Edward E Jeffries, MD
• Konstantine Jegorov, CSFA/CST
• Thomas Abraham Jakob Jeider
• Ariel Jenkins
• Aspen Jenkins
• Cathryn Jenkins
• Connie Jenkins

• Surgical Physician Assistant in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Surgical Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.