JEFFERSON STREET PRIMARY CARE CLINIC
NPI 1124811450
Clinic/Center - Primary Care in Lafayette, LA
About Jefferson Street Primary Care Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JEFFERSON STREET PRIMARY CARE CLINIC (NPI 1124811450) is a healthcare organization registered as a primary care in Lafayette, Louisiana and active in the NPI registry since May 2025. The organization holds a CLIA Waiver certificate valid through December 19, 2026 and lists Antoinette Rabenaldt, Credentialing Coordinator/hr, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 19D2273838
Jefferson Street Primary Care Clinic · Lafayette, LAOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jefferson Street Primary Care Clinic's NPI number?
The NPI number for Jefferson Street Primary Care Clinic is 1124811450. It was assigned to this organization in the NPPES registry on May 28, 2025.
Where is Jefferson Street Primary Care Clinic located?
Jefferson Street Primary Care Clinic is located at 618 Jefferson Blvd, Lafayette, LA 70501. The listed phone number is (337) 345-1709.
What is Jefferson Street Primary Care Clinic's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Does Jefferson Street Primary Care Clinic hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 19D2273838) is associated with this NPI, valid through December 19, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Jefferson Street Primary Care Clinic accept?
Health plans from Blue Cross and Blue Shield of Louisiana and HMO Louisiana list Jefferson Street Primary Care Clinic as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jefferson Street Primary Care Clinic was last updated on February 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jefferson Street Primary Care Clinic · NPI 1124811450
Primary Care organization in Lafayette, Louisiana. Organization record, active in the CMS NPPES registry since May 28, 2025.
## Identity
- **NPI:** 1124811450 (Entity type: Organization)
- **Enumerated:** May 28, 2025
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Antoinette Rabenaldt, CREDENTIALING COORDINATOR/HR
## Practice location
- **Address:** 618 JEFFERSON BLVD, Lafayette, LA 70501-7206
- **Phone:** (337) 345-1709 · **Fax:** (337) 345-4221
## Record status
- **NPPES last updated:** February 11, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1124811450) · Data from the CMS NPPES public registry.