PHYLLIS ST AMANT JACKSON (NPI# 1104283340) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104283340 |
| Entity Type | Individual |
| Full Name | PHYLLIS ST AMANT JACKSON |
| Practice Address |
13317 South Choctaw Drive Suite C3 Baton Rouge LA 70815 |
| Mailing Address |
7852 Phebus Drive Baton Rouge LA 70812-3144 |
| Practice Telephone | 2253646208 |
| Mailing Telephone | 2253646208 |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2016-01-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171W00000X | Contractor | Other Service Providers |
| Street Address |
13317 SOUTH CHOCTAW DRIVE SUITE C3 |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194338343 | Gods Gift Transportation Service | Non-emergency Medical Transport (VAN) | 12333 Flordia Blvd, Suite A, Baton Rouge, LA 70815 | 2020-08-27 |
| 1033733746 | Michael P Juban Dds and J Cody Cowen North Apdllc | Dentist | 8670 Airline Highway, Suite A, Baton Rouge, LA 70815 | 2020-05-29 |
| 1740769264 | Angela Johnson | Driver | 10545 Darryl Dr, Baton Rouge, LA 70815 | 2018-08-07 |
| 1821592924 | Best Choice Transportation LLC | Non-emergency Medical Transport (VAN) | 2035 Wooddale Ave., Baton Rouge, LA 70815 | 2018-03-22 |
| 1679085609 | Kevia Neshell Green | Case Manager/Care Coordinator | 211 Antrim Dr Apt C, Baton Rouge, LA 70815 | 2017-10-31 |
| 1104349828 | Priscilla Carter | Case Manager/Care Coordinator | 9726 West Coronado Drive, Baton Rouge, LA 70815 | 2017-07-25 |
| 1023545902 | Krystal Ross | Counselor | 9420 Lindale Ave Ste A&b, Baton Rouge, LA 70815 | 2017-05-22 |
| 1679014351 | Daniel Joseph Woods | Counselor | 12459 Goodwood Blvd, Baton Rouge, LA 70815 | 2017-03-15 |
| 1073058319 | April Coleman | Case Manager/Care Coordinator | 11534 E Black Oak Dr, Baton Rouge, LA 70815 | 2016-12-22 |
| 1407213499 | Earnestine Payne | Counselor | 1314 S Mike Dr, Baton Rouge, LA 70815 | 2016-01-21 |
| Find all providers in zip 70815 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104476233 | Garrick L Mayweather Sr. | Contractor | 15625 Council Ave, Baton Rouge, LA 70817-5502 | 2019-09-20 |
| 1538510888 | Integrated Healthcare System | Contractor | 18555 Surrey Ct, Baton Rouge, LA 70817-7102 | 2016-06-28 |
| 1720496680 | Carla Thomas | Contractor | 10338 Montrachet Dr, Baton Rouge, LA 70817-7480 | 2014-07-23 |
| 1154741379 | Fritz Hurst | Contractor | 7810 Baja Dr, Baton Rouge, LA 70811-7735 | 2014-04-27 |
| 1184046773 | John Marien | Contractor | 15711 Philemon Thomas Dr, Baton Rouge, LA 70810-5622 | 2014-01-15 |
| 1871837195 | Diana Michele Saul Stewart | Contractor | 12629 Sherbrook Dr, Baton Rouge, LA 70815-6651 | 2012-11-27 |
| 1841421468 | Rodney Jerome Selders | Contractor | 2314 Rhodes Ave, Baton Rouge, LA 70802-1460 | 2009-07-30 |
| 1598947574 | Karen W White | Contractor | 14339 Meadow Ridge Way Dr., Baton Rouge, LA 70817 | 2007-11-30 |
| 1033771233 | Deborah Kaglear | Contractor | 9345 Florida Blvd, Baton Rouge, LA 70815-1122 | 2019-07-08 |
| 1063960722 | Calvin Bonds | Contractor | 9542 Brookline Ave, Suite E, Baton Rouge, LA 70809-1492 | 2016-09-12 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70815 |
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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.