Active NPI
Marissa Danielle Slaughter, COTA
- Occupational Therapy Assistant
- Bossier City, LA
National Provider Identifier
1790280964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 308139
- Practice address
- 4405 Airline Dr
Bossier City, LA 71111-2058 - Phone
- (318) 747-5440
- NPI assigned
- Mar 28, 2018
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 308139 | LA | Primary |
Addresses
Primary practice location
4405 Airline Dr
Bossier City, LA 71111-2058
Mailing address
9525 Stevens Rd
Shreveport, LA 71106-7530
Phone (318) 729-3911
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
| License | State | Type | Specialty |
|---|---|---|---|
| 308139 | LA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522195200000",
"number": "1790280964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9525 STEVENS RD",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711067530",
"telephone_number": "318-729-3911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4405 AIRLINE DR",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711112058",
"telephone_number": "318-747-5440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLAUGHTER",
"first_name": "MARISSA",
"middle_name": "DANIELLE",
"name_prefix": "Miss",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-28",
"last_updated": "2018-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "LA",
"license": "308139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bossier City, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.