Individual provider Active NPI

Jevin Ahmad Rosendoll

  • Counselor
  • Baton Rouge, LA
National Provider Identifier
1922648716
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
10830 Greenwell Springs Rd
Baton Rouge, LA 70814-5014
Phone
(225) 444-5125
NPI assigned
Jan 9, 2020
Last updated
Jan 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary

Addresses

Primary practice location

10830 Greenwell Springs Rd
Baton Rouge, LA 70814-5014

Mailing address

10830 Greenwell Springs Rd
Baton Rouge, LA 70814-5014
Phone (225) 444-5125

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1922648716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10830 GREENWELL SPRINGS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708145014",
            "telephone_number": "225-444-5125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10830 GREENWELL SPRINGS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708145014",
            "telephone_number": "225-444-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENDOLL",
        "first_name": "JEVIN",
        "middle_name": "AHMAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-09",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.

Verify at the official NPI Registry.