Individual provider Active NPI

Kaitlyn Jeansonne, MOT, LOTR

  • Occupational Therapist
  • Mansfield, LA
National Provider Identifier
1174927644
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTT.200776 Issued in LA
Practice address
201 Crosby St
Mansfield, LA 71052-2613
Phone
(318) 872-2836
NPI assigned
Oct 13, 2014
Last updated
May 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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 OTT.200776 LA Primary

Addresses

Primary practice location

201 Crosby St
Mansfield, LA 71052-2613

Mailing address

2044 Pepper Ridge Dr
Shreveport, LA 71115-9525

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

LicenseStateTypeSpecialty
OTT.200776LAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Desoto Parish School Sytem PastSince May 16, 2021 Accepting new patients
Wardell Interests, Inc Past Accepting new patients
Wardell Interest, Inc. Past Accepting new patients
Desoto Parish Public School System PastSince May 16, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1174927644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2044 PEPPER RIDGE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711159525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CROSBY ST",
            "city": "MANSFIELD",
            "state": "LA",
            "postal_code": "710522613",
            "telephone_number": "318-872-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEANSONNE",
        "first_name": "KAITLYN",
        "credential": "MOT, LOTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-13",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": "OTT.200776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; 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.