Jessica I Fussell, MCD

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5626 Issued in LA

Practice address

81337 Ok LN
Covington, LA 70435-8272

Phone

(985) 705-6784

NPI assigned

May 21, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1407064520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81337 OK LN",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704358272",
            "telephone_number": "985-705-6784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81337 OK LN",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704358272",
            "telephone_number": "985-705-6784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19198 Highway 40",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "LA",
            "postal_code": "704359369",
            "country_code": "US",
            "telephone_number": "985-705-6784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUSSELL",
        "first_name": "JESSICA",
        "middle_name": "I",
        "name_prefix": "Mrs.",
        "credential": "MCD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "5626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1714313",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Reneau Froeba, MSW
• Kimberly Buchler Fruge, BCBA, LBA
• Alexandra Fuller, PSYD
• Fundamentals, LLC
• Elizabeth Fuselier, PHARM. D
• Sydney F Fussell, PA
• Jennifer Cox Gagliano, RDN, LDN, CDCES
• Mark Joseph Gagnard, FNP
• Somer Gagnard
• Michele L Gagne, MA BCBA

• Speech-Language Pathologist in Covington, LA
• Providers in Covington, LA by specialty
• Speech-Language Pathologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; 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.