Individual provider Active NPI

Angelle Fruge Driggs, OT

  • Occupational Therapist
  • Eunice, LA
National Provider Identifier
1871580787
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
Z12023 Issued in LA
Practice address
441 Moosa Blvd
Eunice, LA 70535-3627
Phone
(337) 457-8164
Fax
(337) 546-6515
NPI assigned
Oct 5, 2005
Last updated
Apr 28, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Z12023 LA Primary

Addresses

Primary practice location

441 Moosa Blvd
Eunice, LA 70535-3627

Mailing address

441 Moosa Blvd
Eunice, LA 70535-3627
Phone (337) 457-8164

Other identifiers 2

IdentifierTypeStateIssuer
1109061MedicaidLA
1004243MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100924001193 LA Practitioner - Occupational Therapist in Private Practice 5698826147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehab Xcel of Eunice, LLCGroup PAC ID 5890609267, 6 clinicians

Practice addresses (Care Compare)

441 Moosa Blvd
Eunice, LA 70535-3627
Phone (337) 457-8164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
Z12023LAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Xcel of Eunice LLC Occupational Therapist CurrentSince Jul 10, 2001 Accepting new patients
K and S Therapy Past Accepting new patients

Locations

441 Moosa Blvd
Eunice, LA 70535
Phone (337) 457-8164

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1871580787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 MOOSA BLVD",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "705353627",
            "telephone_number": "337-457-8164",
            "fax_number": "337-546-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 MOOSA BLVD",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "705353627",
            "telephone_number": "337-457-8164",
            "fax_number": "337-546-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRIGGS",
        "first_name": "ANGELLE",
        "middle_name": "FRUGE",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": "Z12023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1109061",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004243",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eunice, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.