WEST JEFFERSON PHYSICIAN SERVICES (NPI# 1053486043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053486043 |
| Entity Type | Organization |
| Organization Name | WEST JEFFERSON PHYSICIAN SERVICES |
| Other Organization Name | FAMILY DOCTORS |
| Practice Address |
1111 Medical Center Blvd Suite S850 Marrero LA 70072-3151 |
| Practice Telephone | 5043496450 |
| Practice Fax Number | 5043496454 |
| Mailing Telephone | 5043496450 |
| Mailing Fax Number | 5043496454 |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | HEIDI A GWINN (CREDENTIALING COORD.) |
| Authorized Official Telephone | 5043491297 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1942545 | 05 |
| Other Name | Type Code |
|---|---|
| Family Doctors | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780015784 | West Jefferson Physician Services | Nutritionist | 1121 Medical Center Blvd., West Jefferson Fitness Center, Marrero, LA 70072 | 2013-12-02 |
| 1831266162 | West Jefferson Physician Services | Family Medicine | 5140 Church St, Lafitte, LA 70067-5256 | 2006-11-30 |
| 1669549283 | West Jefferson Physician Services | Pediatrics | 1111 Medical Center Blvd, Suite S650, Marrero, LA 70072-3151 | 2006-11-29 |
| 1790850774 | West Jefferson Physician Services | Family Medicine | 3909 Lapalco Blvd, Suite 100, Harvey, LA 70058-2302 | 2006-11-22 |
| 1114092194 | West Jefferson Physician Services | Internal Medicine | 2845 Manhattan Blvd, Harvey, LA 70058-2987 | 2006-11-22 |
| 1457426439 | West Jefferson Physician Services | Family Medicine | 175 Hector Ave, Gretna, LA 70056-2590 | 2006-11-22 |
| Street Address |
1111 MEDICAL CENTER BLVD SUITE S850 |
| City | MARRERO |
| State | LA |
| Zip Code | 70072-3151 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487657359 | West Jefferson Surgery Center, LLC | Clinic/Center | 1111 Medical Center Blvd, Ste 105n, Marrero, LA 70072-3152 | 2005-05-24 |
| 1972129211 | Marissa Liantonio Miller | Nurse Practitioner | 1111 Medical Center Blvd, Marrero, LA 70072-3151 | 2020-06-23 |
| 1952920324 | Kirstie Rae Schieffler | Physician Assistant | 1111 Medical Center Blvd, Marrero, LA 70072-3151 | 2020-04-15 |
| 1841730918 | Samantha Schenker | Nurse Practitioner | 1111 Medical Center Blvd, N406, Marrero, LA 70072-3151 | 2017-03-08 |
| 1376092379 | Shelli Rodriguez Ergen | Nurse Practitioner | 1111 Medical Center Blvd, Suite South 113, Marrero, LA 70072-3151 | 2016-10-02 |
| 1326418443 | Cain Foot Center, LLC | Podiatrist | 1111 Medical Center Blvd, Suite N-313, Marrero, LA 70072-3151 | 2015-10-01 |
| 1235515693 | Joseph Guarnieri | Eyewear Supplier (Equipment, not the service) | 1111 Medical Center Blvd, Suite N-114, Marrero, LA 70072-3151 | 2015-08-07 |
| 1639552979 | Kelly Thibodeaux | Nurse Practitioner | 1111 Medical Center Blvd, 350s, Marrero, LA 70072-3151 | 2015-07-06 |
| 1629478409 | Ochsner Clinic LLC | General Practice | 1111 Medical Center Blvd, Suite 313n, Marrero, LA 70072-3151 | 2014-08-28 |
| 1285034553 | Raven S Jackson | Pharmacist | 1111 Medical Center Blvd, S 850, Marrero, LA 70072-3151 | 2014-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780232579 | Brittany Inez Young | Technician | 4465 Bay View Drive, Marrero, LA 70072 | 2019-08-27 |
| 1356829774 | Zachary Allen Runge Kleinpeter | Physician Assistant | 1111 Medical Center Blvd Ste S630, Marrero, LA 70072 | 2018-07-30 |
| 1689172611 | Derron White | Specialist | 2324 Barataria Blvd, Marrero, LA 70072 | 2018-01-24 |
| 1477064616 | Bone & Joint, LLC Physical Therapy | Physical Therapist | 4633 Wichers Dr., Marrero, LA 70072 | 2017-10-16 |
| 1477077410 | Darlene Jenkins | Case Manager/Care Coordinator | 7606 Westbank Expy Ste B, Marrero, LA 70072 | 2017-08-01 |
| 1871017186 | Tyra K Haynes | Non-emergency Medical Transport (VAN) | 536 Westwood Drive, Marrero, LA 70072 | 2017-07-28 |
| 1265961536 | Danika Kayelle Frank | Social Worker | 6189 Boutte St, Marrero, LA 70072 | 2017-06-08 |
| 1528596673 | Monica Cheree Mayberry | Counselor | 931 Westwood Dr., Marrero, LA 70072 | 2017-06-01 |
| 1710419197 | Sharla Black | Counselor | 2069 Paine Drive, Marrero, LA 70072 | 2017-04-03 |
| 1699207043 | Tango Austin | Counselor | 2573 Foliage Drive, Marrero, LA 70072 | 2017-04-03 |
| Find all providers in zip 70072 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659696912 | Andrea D. Germond | Internal Medicine | 1101 Medicare Ctr. Blvd., Hospitalist Department, Marrero, LA 70072 | 2010-03-30 |
| 1285893214 | Kimberly Ann Sommers | Internal Medicine | Wjmc Infectious Disease Clinic, 1111 Medical Center Blvd Suite S-850, Marrero, LA 70072 | 2008-06-05 |
| 1376731588 | Charles Simonson | Internal Medicine | 1255 Avenue D, Marrero, LA 70072-3127 | 2007-10-12 |
| 1356531131 | Amanda G. Fontenot | Internal Medicine | 4225 Lapaleo Boulevard, Marrero, LA 70072 | 2007-07-27 |
| 1740345008 | Alan Bernard Halle | Internal Medicine | 1111 Medical Center Blvd Ste S850, Marrero, LA 70072 | 2006-12-27 |
| 1265548416 | Phuong T Vo | Internal Medicine | 7521 Westbank Expy, Suite E, Marrero, LA 70072-2300 | 2006-08-21 |
| 1982615142 | Hong Le Nguyen | Internal Medicine | 1111 Medical Center Blvd # S-570, Marrero, LA 70072-3151 | 2006-08-11 |
| 1790753945 | Ahmad M A Shanableh | Internal Medicine | 824 Avenue F, Marrero, LA 70072-1940 | 2006-03-14 |
| 1164495552 | Sophia L Morris | Internal Medicine | 1101 Medical Ctr. Blvd., Hospitalist Group, Marrero, LA 70072 | 2006-02-08 |
| 1477545309 | Kristi Lynne St Martin | Internal Medicine | 1101 Medical Center Blvd., Attn: Hospitalist Department, Marrero, LA 70072-0000 | 2005-08-17 |
| Find all providers in MARRERO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.