Individual provider Active NPI

Brandi Jamison, APRN

  • Women's Health Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1962168013
Registry record updated Nov 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
210697 Issued in LA
Practice address
5610 Buncombe Rd Apt 204
Shreveport, LA 71129-2687
Phone
(318) 518-1049
NPI assigned
Nov 12, 2021
Last updated
Nov 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
210697OtherLALOUISIANA 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220912000901 LA Practitioner - Nurse Practitioner 8527443506 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
210697LAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Council for Advancement of Social Service and Education CurrentSince Aug 16, 2022 Accepting new patients
Council for Advancement of Social Service and Education Current Accepting new patients
Council for Advancement of Social Service and Education CurrentSince Aug 16, 2022 Accepting new patients
Council for Advancement of Social Service and Education PastSince Aug 2, 2020 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.

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

Verify at the official NPI Registry.