Active NPI
Ansley Fussell, MOT
- Pediatric Occupational Therapist
- Shreveport, LA
National Provider Identifier
1881233039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 120474
- Practice address
- 1033 Wilton PL
Shreveport, LA 71107-2817 - Phone
- (318) 402-2995
- NPI assigned
- Jan 4, 2020
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 120474 | TX | Primary |
Addresses
Primary practice location
1033 Wilton PL
Shreveport, LA 71107-2817
Mailing address
1033 Wilton PL
Shreveport, LA 71107-2817
Other practice location 1
100 E Ferguson St Ste 608
Tyler, TX 75702-5756
Phone (903) 707-0070
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 |
|---|---|---|---|
| 120474 | TX | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578096000000",
"number": "1881233039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1033 WILTON PL",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711072817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1033 WILTON PL",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711072817",
"telephone_number": "318-402-2995"
}
],
"practiceLocations": [
{
"address_1": "100 E Ferguson St Ste 608",
"address_purpose": "LOCATION",
"city": "Tyler",
"state": "TX",
"postal_code": "757025756",
"country_code": "US",
"telephone_number": "903-707-0070",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FUSSELL",
"first_name": "ANSLEY",
"credential": "MOT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-04",
"last_updated": "2020-01-04",
"certification_date": "2020-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "TX",
"license": "120474",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
- Fultz Physical Therapy and Joint Rehab, LLC
- Christopher Fultz, DPT
- Function First Physical Therapy, LLC
- Jacob Wade Funderburk, PLPC
- Dannette Furgerson, AGPCNP
- Zachary Blake Fussell, MSN, APRN, PMHNP-BC
- Michael Futrell, MD
- G Brent Whitton MD and Willis-Knighton Medical Center
- Cathy Barfield Gabriel, LCSW
- Shiva Jashwanth Gaddam
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.