Jennifer Perodeau, LOTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

308111 Issued in LA

Practice address

107 Summer LN
West Monroe, LA 71291-3501

Phone

(318) 396-1969

NPI assigned

Jun 1, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Melanie Massey Physical Therapy Inc

  • Physical Therapist
  • Monroe, LA
  • NPI 1104922475

  Occupational Therapist

  NPD
• Melanie Massey Infant & Toddler LLC

  • Speech-Language Pathologist
  • West Monroe, LA
  • NPI 1447453865

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1881218352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1377",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712941377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 SUMMER LN",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712913501",
            "telephone_number": "318-396-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERODEAU",
        "first_name": "JENNIFER",
        "credential": "LOTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-01",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": "308111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOTR LICENSE",
            "identifier": "308111",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan Edward Pearson, FNP
• Pediatric Clinic of West Monroe
• Pegasus Primary Providers, LLC
• Dawn W Pennebaker, M.D.
• Kenyatta Percy
• Holley Marie Perry, CCC/SLP
• Alicia Hutson Peters, PA
• Kimberly Ann Peters, BCBA, M.S.
• Brenda Zeagler Pettis, RPH
• Melissa Petz, PHARM. D.

• Occupational Therapist in West Monroe, LA
• Providers in West Monroe, LA by specialty
• Occupational Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; 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.