Jacquelyn E Adcock, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

200398 Issued in LA

Practice address

2539 Viking Dr
Suite 101
Bossier City, LA 71111-1611

Phone

(318) 747-8100

Fax

(318) 747-8150

NPI assigned

Oct 25, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bossier Family Medicine, LLCGroup PAC ID 1850318122, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Shreveport-Bossier Health System Hospital, Shreveport, LA, CCN 190041

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bossier Family Medicine, LLC

  • Family Medicine Physician
  • Bossier City, LA
  • NPI 1003032236
  Medicare reassignment Care Compare group
• Bossier Family Medicine, LLC

  • Urgent Care Clinic/Center
  • Bossier City, LA
  • NPI 1629577895
  NPD (past)
• WK Urgent Care Center - Bossier

  • Family Medicine Physician
  • Bossier City, LA
  • NPI 1982640884
  NPD (past)
• WK Urgent Care Center-South

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1891083457
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Health Northern Louisiana

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1417950106
  Care Compare affiliation

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1972803088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2539 VIKING DR",
            "address_2": "SUITE 101",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711111611",
            "telephone_number": "318-747-8100",
            "fax_number": "318-747-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2539 VIKING DR",
            "address_2": "SUITE 101",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711111611",
            "telephone_number": "318-747-8100",
            "fax_number": "318-747-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADCOCK",
        "first_name": "JACQUELYN",
        "middle_name": "E",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-25",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "200398",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "200398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jadcock@bossierfamilymed.com",
            "affiliation": "N",
            "endpointDescription": "Office",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Medical Information",
            "address_1": "2539 Viking Dr",
            "address_2": "Suite 101",
            "city": "Bossier City",
            "state": "LA",
            "country_code": "US",
            "postal_code": "711111611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashley Renee' Adams, LMSW
• Candice Michelle Adams
• Charles Savage Adams, OD
• Ruthie Adams
• Sondra Adams
• Addus One Care LLC
• Oluwasanmi Oloruntebi Adegboyega, DDS
• Advance One Medical Equipment & Supplies LLC.
• Affective Concepts, LLC.
• Affirming Solutions Counseling

• Physician Assistant in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.

Verify at the official NPI Registry.