Jefferson Medical Clinic LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JEFFERSON MEDICAL CLINIC LLC

Practice address

435 Lapalco Blvd Ste 1
Gretna, LA 70056-7375

Phone

(504) 392-4114

Fax

(504) 533-8622

NPI assigned

May 21, 2013

Last updated

Dec 17, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Son Binh NguyenNPI 1710121348

Title

Managing Member

Phone

(504) 392-4114

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Son Binh Nguyen, M.D.

  • Family Medicine Physician
  • Gretna, LA
  • NPI 1710121348
  Medicare reassignment NPD Authorized official
• Ngoc-Thuy Thi Bui, M.D.

  • Family Medicine Physician
  • Gretna, LA
  • NPI 1306080361
  Medicare reassignment NPD
• Bernard Aldrich Landry, M.D.

  • Diagnostic Radiology Physician
  • Cincinnati, OH
  • NPI 1871584714

  LA

  Medicare reassignment NPD
• William Kenneth Mask, M.D.

  • Diagnostic Radiology Physician
  • Durham, NC
  • NPI 1215030507

  LA

  Medicare reassignment NPD
• Frank Voelker III, MD

  • Internal Medicine Physician
  • Covington, LA
  • NPI 1316928260
  Medicare reassignment

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576540800000",
    "number": "1952747602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 LAPALCO BLVD",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700567369",
            "telephone_number": "504-392-4114",
            "fax_number": "504-533-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 LAPALCO BLVD STE 1",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700567375",
            "telephone_number": "504-392-4114",
            "fax_number": "504-533-8622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-21",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "SON",
        "authorized_official_middle_name": "BINH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "504-392-4114"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James P. Marra, M.D., Apmc
• James Renda DMD
• Sophy Ann Jancich, MD
• Janice S. Glenn, M.D. Ampc
• Jason Wonch OD and Associates a P C (EyeMasters)
• Jencare Neighborhood Medical Center WB, LLC (JenCare Neighborhood Medical Center)
• Laura Elizabeth Jennings Tomblin
• Jeff Jeskin, OD
• Jason Jessie
• Job Link, Inc.

• Family Medicine Physician in Gretna, LA
• Providers in Gretna, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.