Lacey Ozburn, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

09814 Issued in LA

Practice address

4616 Highway 84 W
Vidalia, LA 71373-3357

Phone

(318) 336-5400

Fax

(318) 336-8621

NPI assigned

Feb 5, 2018

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

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthpro Heritage Rehab and Fitness LLCGroup PAC ID 6507832573, 976 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Tallulah, LA
  • NPI 1154852382
  Medicare reassignment Care Compare group NPD
• Therapy Center for Physical Rehabilitation and Wellness, LLC

  • Physical Therapist
  • New Roads, LA
  • NPI 1366782120
  Medicare reassignment
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462
  NPD
• Southern Flex Rehabilitation & Consulting, LLC

  • Physical Therapist
  • Metairie, LA
  • NPI 1144559451
  NPD (past)
• Thrive Therapy Services, LLC

  • Physical Therapist
  • St. Francisville, LA
  • NPI 1346702834
  NPD (past)

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

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517788800000",
    "number": "1043719040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4616 HIGHWAY 84 W",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "713733357",
            "telephone_number": "318-336-5400",
            "fax_number": "318-336-8621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4616 HIGHWAY 84 W",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "713733357",
            "telephone_number": "318-336-5400",
            "fax_number": "318-336-8621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OZBURN",
        "first_name": "LACEY",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-05",
        "last_updated": "2018-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "09814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ekaternia Neveykina
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• Northland Hearing Centers, Inc.
• Tiffany M Paul
• Pediatric & Adolescent Clinic of Louisiana LLC
• Perfusion Vascular Vidalia LLC
• Erika Perkins
• Mercedes Phipps

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; 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.