JEREMY CLAIBORNE (NPI# 1609043017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609043017 |
| Entity Type | Individual |
| Full Name | JEREMY CLAIBORNE |
| Credential | MD |
| Practice Address |
510 E. Stoner Avenue Overton Brooks Va Medical Center Shreveport LA 71101 |
| Mailing Address |
223 Medical Center Drive Riverwoods Behavioral Health Riverdale GA 30274 |
| Practice Telephone | 3189905000 |
| Mailing Telephone | 8773945271 |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2017-03-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
204692 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | MEDICARE PTAN | 4R117 | 01 |
| MS | MS MEDICAID | 01733393 | 01 |
| LA | 1053732 | 05 | |
| LA | RAILROAD MEDICARE | P01158547 | 01 |
| Street Address |
510 E. STONER AVENUE OVERTON BROOKS VA MEDICAL CENTER |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679586291 | Vicki Rachal | Social Worker | 510 E. Stoner Avenue, Obvamc (116), Shreveport, LA 71101 | 2006-08-14 |
| 1235363391 | Harold D. Shaver | Counselor | 510 E. Stoner Avenue, Shreveport, LA 71101-4295 | 2009-05-05 |
| 1144474289 | Jenessia L. Cunningham | Social Worker | 510 E. Stoner Avenue, Overton Brooks Va Medical Center, Shreveport, LA 71101-4295 | 2008-11-14 |
| 1740489301 | Dejuana Lachelle Danzell Petteway | Social Worker | 510 E. Stoner Avenue, Shreveport, LA 71101-4295 | 2007-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255988630 | Renee Jewitt | Case Manager/Care Coordinator | 1513 Line Avenue, Suite 225, Shreveport, LA 71101 | 2019-08-21 |
| 1942770094 | Bessie Larry | Case Manager/Care Coordinator | 1513 Line Av, 222, Shreveport, LA 71101 | 2018-12-03 |
| 1750875944 | Jarvis Decarleonne Larry | Community Health Worker | 1513 Line Ave # 222, Shreveport, LA 71101 | 2018-06-20 |
| 1871083485 | Kimberly B. Mcclelland, Lcsw | Counselor | 820 Jordan St. Ste 510w, Shreveport, LA 71101 | 2018-05-18 |
| 1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
| 1528572955 | Spencer Ron Floyd | Counselor | 1717 Marshall Street, Shreveport, LA 71101 | 2017-11-21 |
| 1578088076 | Brittany Morris | Case Manager/Care Coordinator | 1835 Spring Street Annex Building, Shreveport, LA 71101 | 2017-08-07 |
| 1275058794 | Diane Williams | Case Manager/Care Coordinator | 217 Jones St Apt 510, Shreveport, LA 71101 | 2017-08-04 |
| 1386195972 | Jakeya Woodbury | Counselor | 453 Stoner Ave, Shreveport, LA 71101 | 2016-10-18 |
| 1922459643 | Arlene Huling | Counselor | 449 Egan Street, Shreveport, LA 71101 | 2016-06-23 |
| Find all providers in zip 71101 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033320577 | John Wagner | Psychiatry & Neurology | 7330 Fern Ave Ste 704, Shreveport, LA 71105-4985 | 2007-05-25 |
| 1821208224 | Manish Saran | Psychiatry & Neurology | 7591 Fern Avenue, Suite 1705, Shreveport, LA 71105-5749 | 2007-05-23 |
| 1780028613 | Hannah Kathryn Scott | Psychiatry & Neurology | 1501 Kings Hwy, Child & Adolescent Psychiatry, Shreveport, LA 71103-4228 | 2013-04-22 |
| 1043516453 | S and S Psychiatry LLC | Psychiatry & Neurology | 7591 Fern Avenue, Suite 1705, Shreveport, LA 71105-5749 | 2011-02-02 |
| 1487880407 | Sadaf Javaid | Psychiatry & Neurology | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2009-06-04 |
| 1497998835 | Katherine Elise Smith | Psychiatry & Neurology | 1006 Highland Ave, Shreveport, LA 71101-4103 | 2009-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659998896 | Sarah Hanif | Psychiatry & Neurology | 2300 Severn Ave Apt N212, Metairie, LA 70001-1908 | 2020-07-04 |
| 1750808911 | One Telemed LLC | Psychiatry & Neurology | 1001 W Pinhook Road, Building 3 Suite 219, Lafayette, LA 70503 | 2017-08-28 |
| 1194196535 | Advance Telehealth Consulting Solutions, LLC | Psychiatry & Neurology | 1001 W. Pinhook Road, Building 3 Suite 219, Lafayette, LA 70503 | 2015-10-12 |
| 1710305701 | Erin Prince | Psychiatry & Neurology | 1542 Tulane Ave Rm 238a, New Orleans, LA 70112-2865 | 2014-04-07 |
| 1770826620 | Donna Lou | Psychiatry & Neurology | 117 Acadia Ln, Destrehan, LA 70047-3021 | 2013-03-28 |
| 1952643736 | Maegen S Vincent | Psychiatry & Neurology | 131 South Robertson Street, 14th Floor, New Orleans, LA 70112 | 2013-03-20 |
| 1497013676 | Child Counseling Associates | Psychiatry & Neurology | 313 E William David Pkwy, Metairie, LA 70005-3309 | 2012-04-25 |
| 1417214164 | Nicholas Lawrence Lavin | Psychiatry & Neurology | 913 S College Rd Ste 102, Lafayette, LA 70503-3061 | 2012-04-19 |
| 1093090441 | Naomi Es Mann | Psychiatry & Neurology | 5010 Saint Charles Ave, New Orleans, LA 70115-4939 | 2011-10-17 |
| 1497048912 | Lauren Kaczka-weiss | Psychiatry & Neurology | 1440 Canal St # Tb52, New Orleans, LA 70112-2703 | 2011-05-17 |
| Find all providers with the same taxonomy | ||||
| City | SHREVEPORT |
| Zip Code | 71101 |
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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.