Jefferson Pediatric Clinic

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

06128R Issued in LA

Legal business name

JEFFERSON PEDIATRIC CLINIC

Practice address

1111 Medical Center Blvd
Suite N-813
Marrero, LA 70072-3151

Phone

(504) 349-6813

Fax

(504) 349-6832

NPI assigned

Feb 5, 2007

Last updated

Jun 17, 2008By 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

Scotty James Oubre

Title

Office Assistant

Phone

(504) 349-6813

Specialties & licenses 1

Addresses

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 1

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.

• Carlos Alberto Trujillo, M.D.

  • Pediatrics Physician
  • Marrero, LA
  • NPI 1972642171
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1972642197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "SUITE N-813",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-349-6813",
            "fax_number": "504-349-6832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "SUITE N-813",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-349-6813",
            "fax_number": "504-349-6832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON PEDIATRIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "OUBRE",
        "authorized_official_first_name": "SCOTTY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OFFICE ASSISTANT",
        "authorized_official_telephone_number": "504-349-6813"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "06128R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jefferson Parish Hospital Service District #1 (West Jefferson Medical Center)
• Jefferson Parish Human Services Authority
• Jefferson Parish Public School System
• Jefferson Parish Public School System
• Jefferson Parish Public School System
• Jefferson Physician Imaging Center LLC
• Jefferson Radiology Associates, Inc
• Darlene Jenkins, LCSW
• David Lee Jenkins
• Jennifer Jester, RPH

• Pediatrics Physician in Marrero, LA
• Providers in Marrero, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.