EAST JEFFERSON PHYSICIANS GROUP LLC (NPI# 1922293372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922293372 |
| Entity Type | Organization |
| Organization Name | EAST JEFFERSON PHYSICIANS GROUP LLC |
| Practice Address |
4300 Houma Blvd. Ste. 202 Metairie LA 70006-2924 |
| Practice Telephone | 5045036791 |
| Practice Fax Number | 5045036791 |
| Mailing Telephone | 5045036791 |
| Mailing Fax Number | 5045036791 |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2017-01-05 |
| Authorized Official Name | MISS JENNY REESE (DIRECTOR) |
| Authorized Official Telephone | 5045036783 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1337951 | 05 | |
| LA | RAILROAD MEDICARE | DF2307 | 01 |
| Street Address |
4300 HOUMA BLVD. STE. 202 |
| City | METAIRIE |
| State | LA |
| Zip Code | 70006-2924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801233648 | Metairie Physician Services Inc. | Physical Medicine & Rehabilitation | 4300 Houma Blvd., Ste. 202, Metairie, LA 70006-2924 | 2013-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437786365 | Christina Alder Humble | Behavior Technician | 4201 N 1-10 Service Road W., Metairie, LA 70006 | 2020-03-23 |
| 1285270959 | Brittanie Renee Tank | Behavior Technician | 4201 N 1-10 Service Rd, W, Metairie, LA 70006 | 2019-11-18 |
| 1447896105 | Jacob Dent Dds Dentists of Metairie A Professional Corporation | Dentist | 5201 Veterans Memorial Blvd., Suite A, Metairie, LA 70006 | 2019-11-18 |
| 1417504861 | Caryn Tesia Washington | Behavior Technician | 4201 N 1-10 Service Rd W., Metarie, LA 70006 | 2019-08-21 |
| 1568023356 | Brittany Nicole Davis | Behavioral Analyst | 4201 N-i 10 Service Rd, Metairie, LA 70006 | 2019-06-24 |
| 1295393650 | Beth Ann Martin | Behavior Technician | 4201 N. Service Road W, Metairie, LA 70006 | 2019-05-31 |
| 1942866561 | Manunique Johnson | Behavior Technician | 4201 N-1-10 Service Rd W., Metairie, LA 70006 | 2019-05-20 |
| 1972068419 | Stacey R Phipps | Behavior Technician | 4201 N 1-10 Service Rd. W., Metairie, LA 70006 | 2019-02-08 |
| 1740752799 | Na'triana Clark | Behavior Technician | 4210 N I-10 Service Rd, Metairie, LA 70006 | 2018-12-31 |
| 1861969131 | Lauren Hay Hughes | Behavior Technician | 4201 N 1-10 Service Rd. West, Metairie, LA 70006 | 2018-10-25 |
| Find all providers in zip 70006 | ||||
| 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 |
|---|---|---|---|---|
| 1760915631 | Andrew Burke | Internal Medicine | 235 Helios Ave, Metairie, LA 70005-3754 | 2017-04-07 |
| 1295114031 | Morning Star Rising, Inc. | Internal Medicine | 3032 Ridgelake Dr, Suite 100, Metairie, LA 70002-4973 | 2015-05-27 |
| 1740613827 | Lawrence Garvey Bole | Internal Medicine | 400 Rue St Ann, Unit 214, Metairie, LA 70005 | 2013-08-13 |
| 1922448372 | Bronwyn Leblanc | Internal Medicine | 4424 Conlin St Ste 2b, Metairie, LA 70006-2147 | 2013-06-30 |
| 1033461900 | Laura Ellen Trunk | Internal Medicine | 1200 Andrews Ave, Metairie, LA 70005-1706 | 2012-10-02 |
| 1780987909 | Kenneth Mcleod Jr. | Internal Medicine | 351 Elmeer Ave, Metairie, LA 70005 | 2010-12-09 |
| 1558682567 | David N Gachoka | Internal Medicine | 704 N Woodlawn Ave Apt A, Metairie, LA 70001-4760 | 2010-06-14 |
| 1316264229 | Ahmed Ghouse Mohiuddin | Internal Medicine | 4315 Houma Blvd Ste 500, Metairie, LA 70006-2942 | 2010-05-02 |
| 1457675415 | David Anderson Pollet | Internal Medicine | 4200 Houma Blvd Fl 6, Metairie, LA 70006-2970 | 2010-03-19 |
| 1598935314 | Curtis D Prowell Jr. | Internal Medicine | 4300 Houma Blvd Fl 6, Metairie, LA 70006-2932 | 2008-03-07 |
| Find all providers in METAIRIE | ||||
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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.