Individual provider Active NPI

Feshondra Fereca Mone Tripp, MOTR/L

  • Occupational Therapist
  • Canton, MS
National Provider Identifier
1174850192
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT3015 Issued in MS
Practice address
117 Brigade Ave
Canton, MS 39046-8025
Phone
(601) 720-5793
NPI assigned
Nov 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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 OT3015 MS Primary

Addresses

Primary practice location

117 Brigade Ave
Canton, MS 39046-8025

Mailing address

117 Brigade Ave
Canton, MS 39046-8025
Phone (601) 720-5793

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230224001675 MS Practitioner - Occupational Therapist in Private Practice 2264805035 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healing Hands Rehabilitation Services LLC 3 clinicians

Practice addresses (Care Compare)

105 Lexington Dr
Suite H
Gluckstadt, MS 39110-6646
Phone (601) 910-7300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Feb 12, 2023 Accepting new patients
Healing Hands Rehabilitation Services, LLC CurrentSince Nov 24, 2024 Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Feb 12, 2023 Accepting new patients
Healing Hands Rehabilitation Services, LLC CurrentSince Jan 6, 2025 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

105 Lexington Dr
Ste H
Gluckstadt, MS 39110
Phone (601) 910-7300

Organizations & group practices 4

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": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1174850192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 BRIGADE AVE",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390468025",
            "telephone_number": "601-720-5793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 BRIGADE AVE",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390468025",
            "telephone_number": "601-720-5793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIPP",
        "first_name": "FESHONDRA",
        "middle_name": "FERECA MONE",
        "name_prefix": "Mrs.",
        "credential": "MOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-12",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT3015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.