Active NPI
Jonai Alisia Fullard
- Social Worker
- Richardson, TX
National Provider Identifier
1174385264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 112176
- Practice address
- 411 Buckingham Rd Apt 1331
Richardson, TX 75081-5790 - Phone
- (972) 454-0414
- NPI assigned
- Jan 25, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 112176 | TX | Primary |
Addresses
Primary practice location
411 Buckingham Rd Apt 1331
Richardson, TX 75081-5790
Mailing address
411 Buckingham Rd Apt 1331
Richardson, TX 75081-5790
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112176 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706400000000",
"number": "1174385264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 BUCKINGHAM RD APT 1331",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750815790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 BUCKINGHAM RD APT 1331",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750815790",
"telephone_number": "972-454-0414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLARD",
"first_name": "JONAI",
"middle_name": "ALISIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-25",
"last_updated": "2024-01-28",
"certification_date": "2024-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TX",
"license": "112176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richardson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.