JEFFERSON COMMUNITY HEALTH CARE CENTERS INC (NPI# 1124000773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124000773 |
| Entity Type | Organization |
| Organization Name | JEFFERSON COMMUNITY HEALTH CARE CENTERS INC |
| Practice Address |
4028 Highway 90 W Avondale LA 70094-2622 |
| Practice Telephone | 5044362223 |
| Practice Fax Number | 5044362224 |
| Mailing Telephone | 5044362223 |
| Mailing Fax Number | 5044362224 |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MISS STACEY MARIE LOVELL (BILLING OFFICE/CREDENTIALING) |
| Authorized Official Telephone | 5044362223 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1447196 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205470432 | Jefferson Community Health Care Centers Inc | Clinic/Center | 7201 Lapalco Blvd, Marrero, LA 70072-4523 | 2019-10-31 |
| 1639321714 | Jefferson Community Health Care Centers Inc | Community/Behavioral Health | 3211 Highway 1, Grand Isle, LA 70358 | 2008-10-21 |
| 1093759888 | Jefferson Community Health Care Centers Inc | Clinic/Center | 1855 Ames Blvd, Suite B, Marrero, LA 70072-3429 | 2006-06-15 |
| 1255977245 | Jefferson Community Health Care Centers Inc | Pharmacy | 3932 Highway 90 W, Avondale, LA 70094-2648 | 2019-11-25 |
| 1891831376 | Jefferson Community Health Care Centers Inc | Family Medicine | 11312 Jefferson Hwy, River Ridge, LA 70123-1709 | 2007-01-30 |
| Street Address |
4028 HIGHWAY 90 W |
| City | AVONDALE |
| State | LA |
| Zip Code | 70094-2622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063712107 | Jefferson Community Health Care Centers | Clinic/Center | 4028 Highway 90 W, Avondale, LA 70094-2622 | 2010-10-22 |
| 1417106485 | Lajuan Marchee' Verrett | Nurse Practitioner | 4028 Highway 90 W, Avondale, LA 70094-2622 | 2008-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326549593 | Jesucare Transportation Services | Non-emergency Medical Transport (VAN) | 1409 West Dr #b, Westwego, LA 70094 | 2018-02-23 |
| 1861921157 | Jelessa Penn | Specialist/Technologist | 43 Lucille St., Waggaman, LA 70094 | 2017-06-08 |
| 1538691035 | Raqual Badeaux | Case Manager/Care Coordinator | 705 Chipley St, Westwego, LA 70094 | 2017-04-03 |
| 1316486905 | Hong Tran | Pharmacist | 173 June Dr., Avondale, LA 70094 | 2017-02-16 |
| 1114466703 | Dwayne M Hawkins | Counselor | 321 Georgetown Dr., Avondale, LA 70094 | 2017-02-16 |
| 1568912251 | Keyanna Adams | Case Manager/Care Coordinator | 41 Clifford Ct, Westwego, LA 70094 | 2016-10-06 |
| 1669838074 | Joann Blair | Counselor | 251 Laroussini St, Westwego, LA 70094 | 2016-01-14 |
| 1538524699 | Chevella Austin | Counselor | 269 Glendella Dr, Avondale, LA 70094 | 2015-12-16 |
| 1164895025 | Tiffeny Haynes | Case Manager/Care Coordinator | 104 Dillard Dr, Westwego, LA 70094 | 2015-11-01 |
| 1952710766 | Thien Nguyen | Dentist | 125 Poplar St., Westwego, LA 70094 | 2014-08-06 |
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| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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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.