Active NPI
Brandi Jamison, APRN
- Women's Health Nurse Practitioner
- Shreveport, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 210697
- Practice address
- 5610 Buncombe Rd Apt 204
Shreveport, LA 71129-2687 - Phone
- (318) 518-1049
- NPI assigned
- Nov 12, 2021
- Last updated
- Nov 13, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 210697 | LA | Primary |
Addresses
Primary practice location
5610 Buncombe Rd Apt 204
Shreveport, LA 71129-2687
Mailing address
5610 Buncombe Rd Apt 204
Shreveport, LA 71129-2687
Phone (318) 518-1049
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 210697 | Other | LA | LOUISIANA STATE BOARD OF NURSING |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2120 Bert Kouns Industrial Loop
Shreveport, LA 71118-3351
Phone 31868833501230
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 210697 | LA | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Council for Advancement of Social Service and Education | Current | Accepting new patients | |
| Council for Advancement of Social Service and Education | Current | Accepting new patients | |
| Council for Advancement of Social Service and Education | Current | Accepting new patients | |
| Council for Advancement of Social Service and Education | Past | Accepting new patients |
Locations
2120 Airline Dr
Bossier City, LA 71111
Phone (318) 688-3350
907 Polk St
Mansfield, LA 71052
Phone (318) 688-3350
1560 Irving Pl
Shreveport, LA 71101
Phone (318) 212-1194
2120 Bert Kouns Industrial Loop
Ste A
Shreveport, LA 71118
Phone (318) 688-3350
2120 Bert Kouns Industrial Loop
Ste H
Shreveport, LA 71118
2120 Bert Kouns Industrial Loop
Ste Kl
Shreveport, LA 71118
Phone (318) 688-3350
149 Stone Creek Rd
Stonewall, LA 71078
Phone (318) 688-3350
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Casse/Community Health Institute
- Federally Qualified Health Center (FQHC)
- Mansfield, LA
- NPI 1285942284
-
dba CASSE/CHI Bert Kouns Site
- Federally Qualified Health Center (FQHC)
- Shreveport, LA
- NPI 1134532062
-
dba CASSE - DIAMC Health Center
- Federally Qualified Health Center (FQHC)
- Shreveport, LA
- NPI 1467061515
-
dba CASSE - Shreveport Pediatrics
- Federally Qualified Health Center (FQHC)
- Shreveport, LA
- NPI 1306455456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636761600000",
"number": "1962168013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5610 BUNCOMBE RD APT 204",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711292687",
"telephone_number": "318-518-1049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5610 BUNCOMBE RD APT 204",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711292687",
"telephone_number": "318-518-1049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMISON",
"first_name": "BRANDI",
"credential": "APRN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-11-12",
"last_updated": "2021-11-13",
"certification_date": "2021-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "LA",
"license": "210697",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LOUISIANA STATE BOARD OF NURSING",
"identifier": "210697",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.