| Jefferson Community Health Care Centers, Inc | |
|
3932 Highway 90 W Avondale LA 70094-2648 | |
| (504) 436-2223 | |
| (504) 436-2224 |
| Full Name | Jefferson Community Health Care Centers, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3932 Highway 90 W, Avondale, Louisiana |
| Authorized Official Name and Position | Joelle M Jessie Skinner (BILLING SPECIALIST) |
| Authorized Official Contact | 5044378523 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Community Health Care Centers, Inc 4028 U S Highway 90 Avondale LA 70094 Ph: (504) 436-2223 | Jefferson Community Health Care Centers, Inc 3932 Highway 90 W Avondale LA 70094-2648 Ph: (504) 436-2223 |
| NPI Number | 1558419275 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 08/03/2021 |
| Medicare PECOS PAC ID | 7911961115 |
|---|---|
| Medicare Enrollment ID | O20041117000594 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558419275 | NPI | - | NPPES |
| 1452793 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Jeremy G Dumas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104808757 PECOS PAC ID: 3779488515 Enrollment ID: I20031204000445 |
| Provider Name | Vadim R Gelman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891717393 PECOS PAC ID: 8426002346 Enrollment ID: I20050303000550 |
| Provider Name | Renetta W Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366427460 PECOS PAC ID: 1951305564 Enrollment ID: I20060912000507 |
| Provider Name | Maritza E Salgado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902884158 PECOS PAC ID: 7214028315 Enrollment ID: I20070803000184 |
| Provider Name | George Edward Ray |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1013959030 PECOS PAC ID: 5496852824 Enrollment ID: I20100626000052 |
| Provider Name | Bridgette S Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376811067 PECOS PAC ID: 8022270479 Enrollment ID: I20120501000078 |
| Provider Name | Vonder W Mcneil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659502987 PECOS PAC ID: 2062681976 Enrollment ID: I20131218000983 |
| Provider Name | Maneesh Gupta |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1417271420 PECOS PAC ID: 7214221092 Enrollment ID: I20160803000076 |
| Provider Name | Conar P Fitton |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1316182744 PECOS PAC ID: 2264626936 Enrollment ID: I20161010001360 |
| Provider Name | John B Rhodes |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023350816 PECOS PAC ID: 9436455565 Enrollment ID: I20161110000408 |
| Provider Name | Cody Roi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518228212 PECOS PAC ID: 8224308762 Enrollment ID: I20170717001959 |
| Provider Name | Frank P De Paula |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821443581 PECOS PAC ID: 7911285432 Enrollment ID: I20190715003279 |
| Provider Name | Breiyon Roncal Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013544352 PECOS PAC ID: 1951712165 Enrollment ID: I20201119000919 |
| Provider Name | Sabrina Hunter Spears |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518699255 PECOS PAC ID: 1355723644 Enrollment ID: I20220803001367 |
| Provider Name | Joan Cooper-rainey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598474157 PECOS PAC ID: 2264803642 Enrollment ID: I20230123000653 |
| Provider Name | Antonia K Traina |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992264139 PECOS PAC ID: 7517293855 Enrollment ID: I20230519000174 |
| Provider Name | Travis Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356611719 PECOS PAC ID: 8022542612 Enrollment ID: I20241105001085 |
Jefferson Community Health Care Centers Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4028 Highway 90 W, Avondale, LA 70094 Phone: 504-436-2223 Fax: 504-436-2224 | |
Access Health Louisiana Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 178 Millie Dr, Avondale, LA 70094 Phone: 866-530-6111 |