Active NPI
Beverly M Jeffery
- Peer Specialist
- Slidell, LA
National Provider Identifier
1932624467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 118 Village St
Slidell, LA 70458-5302 - Phone
- (601) 618-4083
- NPI assigned
- Aug 5, 2017
- Last updated
- Mar 19, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Peer Specialist | 175T00000X | NU | Primary | |
| Behavior Technician | 106S00000X | NU |
Addresses
Primary practice location
118 Village St
Slidell, LA 70458-5302
Mailing address
8326 Kelwood Ave
Baton Rouge, LA 70806-4803
Phone (601) 618-4083
Other practice location 1
4131 Crane Brook Way
Peabody, MA 01960-8527
Phone (601) 618-4083
Other practice location 2
4131 Crane Brook Way
Peabody, MA 01960-8527
Phone (601) 618-4083
Other practice location 3
4201 N I 10 Service Rd W
Metairie, LA 70006
Phone (601) 618-4083
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": "1501891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584576000000",
"number": "1932624467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8326 KELWOOD AVE",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708064803",
"telephone_number": "601-618-4083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 VILLAGE ST",
"city": "SLIDELL",
"state": "LA",
"postal_code": "704585302",
"telephone_number": "601-618-4083"
}
],
"practiceLocations": [
{
"address_1": "4131 Crane Brook Way",
"address_purpose": "LOCATION",
"city": "Peabody",
"state": "MA",
"postal_code": "019608527",
"country_code": "US",
"telephone_number": "601-618-4083",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4131 Crane Brook Way",
"address_purpose": "LOCATION",
"city": "Peabody",
"state": "MA",
"postal_code": "019608527",
"country_code": "US",
"telephone_number": "601-618-4083",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4201 N I 10 Service Rd W",
"address_purpose": "LOCATION",
"city": "Metairie",
"state": "LA",
"postal_code": "70006",
"country_code": "US",
"telephone_number": "601-618-4083",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JEFFERY",
"first_name": "BEVERLY",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-05",
"last_updated": "2020-03-19",
"certification_date": "2020-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Slidell, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.