Individual provider Active NPI

Jessie Fry

  • Speech-Language Pathologist
  • Houma, LA
National Provider Identifier
1710767934
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9456 Issued in LA
Practice address
621 Bayou Dularge Rd
Houma, LA 70363-7608
Phone
(985) 303-4809
NPI assigned
Oct 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 9456 LA Primary

Addresses

Primary practice location

621 Bayou Dularge Rd
Houma, LA 70363-7608

Mailing address

201 Stadium Dr
Houma, LA 70360-2732
Phone (985) 876-7400

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
9456LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Terrebonne Parish School Board PastSince Oct 8, 2023 Accepting new patients
Terrebonne Parish School Board PastSince Oct 8, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1710767934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 STADIUM DR",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703602732",
            "telephone_number": "985-876-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 BAYOU DULARGE RD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703637608",
            "telephone_number": "985-303-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "JESSIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-04",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "9456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.