Individual provider Active NPI

Jana Fuller Ferchaud, OT

  • Occupational Therapist
  • Monroe, LA
National Provider Identifier
1053447649
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1605 Stubbs Ave
Monroe, LA 71201-5629
Phone
(318) 388-8414
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X LA Primary

Addresses

Primary practice location

1605 Stubbs Ave
Monroe, LA 71201-5629

Mailing address

105 Eagle Lake Dr
West Monroe, LA 71291-8753

Other identifiers 1

IdentifierTypeStateIssuer
1456756MedicaidLA

Other names 1

  • Jana Rebecca Fuller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Building Futures Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1053447649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 EAGLE LAKE DR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712918753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 STUBBS AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712015629",
            "telephone_number": "318-388-8414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERCHAUD",
        "first_name": "JANA",
        "middle_name": "FULLER",
        "name_prefix": "Ms.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1456756",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANA",
            "last_name": "FULLER",
            "middle_name": "REBECCA",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.