Prism II, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PRISM II, LLC

Practice address

1005 Fisher Rd
Many, LA 71449-3833

Phone

(318) 256-0800

Fax

(318) 256-0801

NPI assigned

Apr 14, 2010

Last updated

Apr 14, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joe Bienvenu, OT

Title

Partner/Managing Operator

Phone

(318) 238-2810

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271203200000",
    "number": "1023334117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 FISHER RD",
            "city": "MANY",
            "state": "LA",
            "postal_code": "714493833",
            "telephone_number": "318-256-0800",
            "fax_number": "318-256-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 FISHER RD",
            "city": "MANY",
            "state": "LA",
            "postal_code": "714493833",
            "telephone_number": "318-256-0800",
            "fax_number": "318-256-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISM II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-14",
        "last_updated": "2010-04-14",
        "status": "A",
        "authorized_official_last_name": "BIENVENU",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "PARTNER/MANAGING OPERATOR",
        "authorized_official_telephone_number": "318-238-2810",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1362630",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Many, LA
• Providers in Many, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; 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.