Organization Active NPI

Fussell Health, LLC

  • Family Medicine Physician
  • Mandeville, LA
National Provider Identifier
1528764313
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FUSSELL HEALTH, LLC
Practice address
784 Asbury Dr
Mandeville, LA 70471-1844
Phone
(985) 287-1579
NPI assigned
Feb 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Authorized official

Name
Catherine Fussell, MDNPI 1750822037
Title
Owner
Phone
(985) 287-1579

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

784 Asbury Dr
Mandeville, LA 70471-1844

Mailing address

784 Asbury Dr
Mandeville, LA 70471-1844
Phone (985) 287-1579

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230330000531 LA Part B Supplier - Clinic/Group Practice 0446624605 Receives reassigned benefits from 4 practitioners
Practice locations: Covington, LA

National Provider Directory

National Provider Directory

Locations

19349 N 12th St
Covington, LA 70433
Phone (985) 635-5537

784 Asbury Dr
Mandeville, LA 70471
Phone (985) 287-1579

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1528764313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 ASBURY DR",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704711844",
            "telephone_number": "985-287-1579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 ASBURY DR",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704711844",
            "telephone_number": "985-287-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUSSELL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-02",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A",
        "authorized_official_last_name": "FUSSELL",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-287-1579",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.