Active NPI
Jessica T Fussell, PA
- Physician Assistant
- Opelousas, LA
National Provider Identifier
1366779175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA200328
- Practice address
- 703 E Prudhomme St
Opelousas, LA 70570-6494 - Phone
- (337) 942-7192
- Fax
- (337) 942-5940
- NPI assigned
- Nov 16, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA200328 | LA | Primary |
Addresses
Primary practice location
703 E Prudhomme St
Opelousas, LA 70570-6494
Mailing address
120 Rue Louis Xiv
Lafayette, LA 70508-5739
Phone (337) 769-7779
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA200328 | LA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Physical Medicine Center, Inc. | 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.
-
- Physical Therapist
- Lafayette, LA
- NPI 1679589915
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501200000000",
"number": "1366779175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 RUE LOUIS XIV",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705085739",
"telephone_number": "337-769-7779",
"fax_number": "337-769-7788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 E PRUDHOMME ST",
"city": "OPELOUSAS",
"state": "LA",
"postal_code": "705706494",
"telephone_number": "337-942-7192",
"fax_number": "337-942-5940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUSSELL",
"first_name": "JESSICA",
"middle_name": "T",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-16",
"last_updated": "2017-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "LA",
"license": "PA200328",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Opelousas, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.