Individual provider Active NPI

Casey Lafontaine, OT

  • Occupational Therapist
  • Picayune, MS
National Provider Identifier
1356174833
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1620 Highway 11 N Ste C
Picayune, MS 39466-2070
Phone
(769) 242-2626
Fax
(769) 242-2685
NPI assigned
Aug 21, 2024
Last updated
Aug 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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 NU Primary

Addresses

Primary practice location

1620 Highway 11 N Ste C
Picayune, MS 39466-2070

Mailing address

1620 Highway 11 N Ste C
Picayune, MS 39466-2070
Phone (769) 242-2626

Other practice location 1

1601 Central Ave W
Wiggins, MS 39577-2401
Phone (601) 716-3196

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240905002049 MS Practitioner - Occupational Therapist in Private Practice 0648710681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Physical Therapy Clinic IncGroup PAC ID 6103167184, 13 clinicians

Practice addresses (Care Compare)

1620 Hwy 11 N
Suite C
Picayune, MS 39466-2070
Phone (769) 242-2626

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Physical Therapy Clinic, Inc. Occupational Therapist CurrentSince Jul 22, 2024 Accepting new patients

Locations

1620 Highway 11 N
Ste C
Picayune, MS 39466
Phone (769) 242-2626

1601 Central Ave W
Wiggins, MS 39577
Phone (601) 716-3196

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, 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": "1724198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1356174833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 HIGHWAY 11 N STE C",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394662070",
            "telephone_number": "769-242-2626",
            "fax_number": "769-242-2685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 HIGHWAY 11 N STE C",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394662070",
            "telephone_number": "769-242-2626",
            "fax_number": "769-242-2685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Central Ave W",
            "address_purpose": "LOCATION",
            "city": "Wiggins",
            "state": "MS",
            "postal_code": "395772401",
            "country_code": "US",
            "telephone_number": "601-716-3196",
            "fax_number": "601-974-9919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAFONTAINE",
        "first_name": "CASEY",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-21",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Picayune, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.