Individual provider Active NPI

Jessica Fontenot, PHARMD

  • Pharmacist
  • Lafayette, LA
National Provider Identifier
1841699865
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
017794 Issued in LA
Practice address
3142 Ambassador Caffery Pkwy
Pharmacy
Lafayette, LA 70506-7210
Phone
(337) 989-4095
Fax
(337) 989-4097
NPI assigned
Aug 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 017794 LA Primary

Addresses

Primary practice location

3142 Ambassador Caffery Pkwy
Pharmacy
Lafayette, LA 70506-7210

Mailing address

3142 Ambassador Caffery Pkwy
Pharmacy
Lafayette, LA 70506-7210
Phone (337) 989-4095

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
017794LAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407974400000",
    "number": "1841699865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3142 AMBASSADOR CAFFERY PKWY",
            "address_2": "PHARMACY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705067210",
            "telephone_number": "337-989-4095",
            "fax_number": "337-989-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3142 AMBASSADOR CAFFERY PKWY",
            "address_2": "PHARMACY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705067210",
            "telephone_number": "337-989-4095",
            "fax_number": "337-989-4097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTENOT",
        "first_name": "JESSICA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "017794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; 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.