Active NPI
Miguel Andres Larrea, PT, DPT
- Physical Therapist
- Slidell, LA
National Provider Identifier
1023466307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 09356R
- Practice address
- 2965 Gause Blvd E
Slidell, LA 70461-4154 - Phone
- (985) 231-6480
- NPI assigned
- May 27, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 09356R | LA | Primary |
Addresses
Primary practice location
2965 Gause Blvd E
Slidell, LA 70461-4154
Mailing address
2965 Gause Blvd E
Slidell, LA 70461-4154
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09356R | LA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464307200000",
"number": "1023466307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2965 GAUSE BLVD E",
"city": "SLIDELL",
"state": "LA",
"postal_code": "704614154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2965 GAUSE BLVD E",
"city": "SLIDELL",
"state": "LA",
"postal_code": "704614154",
"telephone_number": "985-231-6480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARREA",
"first_name": "MIGUEL",
"middle_name": "ANDRES",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-27",
"last_updated": "2016-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "09356R",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Slidell, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.