JEFFERSON STREET PRIMARY CARE CLINIC
NPI 1124811450
Clinic/Center - Primary Care in Lafayette, LA
NPI Status: Active since May 28, 2025
Contact Information
618 JEFFERSON BLVD
LAFAYETTE, LA
ZIP 70501
Phone: (337) 345-1709
Fax: (337) 345-4221
- Organization
- Clinic/Center
- Primary Care
- Accepts Insurance
- CLIA Number: 19D2273838
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-19-2026
About JEFFERSON STREET PRIMARY CARE CLINIC
This page provides the complete NPI Profile along with additional information for Jefferson Street Primary Care Clinic, a primary care provider established in Lafayette, Louisiana operating as a Clinic/center, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1124811450 assigned on May 2025. The practitioner's primary taxonomy code is 261QP2300X. The provider is registered as an organization and their NPI record was last updated February 2026. The authorized official of this NPI record is Antoinette Rabenaldt (Credentialing Coordinator/hr)
- NPI
- 1124811450
- Provider Name
- JEFFERSON STREET PRIMARY CARE CLINIC
- Entity Type
- Organization
- Location Address
- 618 JEFFERSON BLVD LAFAYETTE, LA 70501
- Location Phone
- (337) 345-1709
- Location Fax
- (337) 345-4221
- Mailing Address
- 302 HACKER ST NEW IBERIA, LA 70560
- Mailing Phone
- (337) 330-2576
- Mailing Fax
- (337) 345-4221
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-28-2025
- Last Update Date
- 02-11-2026
- Code Navigator
A primary care provider (PCP) like Jefferson Street Primary Care Clinic sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Primary Care
- Taxonomy Code
- 261QP2300X
- Type
- Ambulatory Health Care Facilities
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Max 70/50 $6700 with 2 $0 PCP Virtual Visits HSA Eligible - PPO
- Blue Max 80/60 $1500 with 2 $0 PCP Virtual Visits - PPO
- Blue Max Copay (PCP) 50/50 $3300 with 2 $0 PCP Virtual Visits - PPO
- Blue Max Copay (PCP) 50/50 $7500 Standardized HSA Eligible - PPO
- Blue Max Copay (PCP) 60/40 $6000 Standardized - PPO
- Blue Max Copay (PCP) 75/55 $2000 Standardized - PPO
- Blue Saver 60/40 $6100 - PPO
- Blue Saver 90/70 $3400 - PPO
- Blue POS 60/40 $6500 with 2 $0 PCP Virtual Visits HSA Eligible - POS
- Blue POS 80/60 $3200 with 2 $0 PCP Virtual Visits - POS
- Blue POS 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible - POS
- Blue POS Copay (PCP) 50/50 $7500 Standardized HSA Eligible - POS
- Blue POS Copay (PCP) 60/40 $6000 Standardized - POS
- Blue POS Copay (PCP) 75/55 $2000 Standardized - POS
- Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits - POS
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 19D2273838
- Facility Type
- Physician Office
- Certificate Effective Date
- December 20, 2024
- Certificate Expiration Date
- December 19, 2026
- Laboratory Director
- MYISHA JOHNSON - LEDET
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Jefferson Street Primary Care Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1124811450, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 50. The final step is to find the difference between that total and the next multiple of ten (50 - 50 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 50 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124811450, enumerated as an "organization" on May 28, 2025.
The provider is located at 618 JEFFERSON BLVD LAFAYETTE, LA 70501 and the phone number is (337) 345-1709.
Clinic/Center with taxonomy code 261QP2300X and a focus in Primary Care.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Louisiana and HMO. Please consult your insurance carrier or call the provider to verify.
