JENNINGS PEDIATRIC CENTER LLC NPI 1821507542

NPI Information

  • NPI: 1821507542
  • Provider Name: JENNINGS PEDIATRIC CENTER, LLC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • CLIA Number: 19D0877652
  • Address: 1615 JOHNSON ST STE A
    JENNINGS, LA
    ZIP 70546
  • Phone: (337) 824-3446

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NPI Details

JENNINGS PEDIATRIC CENTER, LLC is a clinic center in Jennings, LA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). JENNINGS PEDIATRIC CENTER, LLC NPI is 1821507542. The provider is registered as an organization entity type.

The provider's business location address is:

1615 JOHNSON ST STE A
JENNINGS, LA
ZIP 70546-650
Phone: (337) 824-3446
Fax: (337) 824-7990

The provider's authorized official is Mikki D Monceaux .
The authorized official title is Office Nurse and has the following contact phone number (337) 824-3446.

The CLIA number assigned to this NPI record is 19D0877652 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/26/2017 and was last updated on 9/12/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/Center08542RLOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11649651571MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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