Bayou Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

BAYOU PHYSICAL THERAPY, LLC

Practice address

4112 Lake St Ste 600
Lake Charles, LA 70605-4532

Phone

(337) 602-8614

Fax

(225) 282-2890

NPI assigned

Dec 19, 2017

Last updated

Jun 3, 2024By 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

Jason Spooner, DPTNPI 1922513027

Title

Owner

Phone

(337) 602-8614

Specialties & licenses 2

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jason Randall Spooner, PT, DPT, RN

  • Physical Therapist
  • Lake Charles, LA
  • NPI 1922513027
  Authorized official Same address or phone
• Randa Renee Sampere, PT

  • Physical Therapist
  • Corpus Christi, TX
  • NPI 1598302143
  NPD

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1043726631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4112 LAKE ST STE 600",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054532",
            "telephone_number": "337-602-8614",
            "fax_number": "225-282-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 LAKE ST STE 600",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054532",
            "telephone_number": "337-602-8614",
            "fax_number": "225-282-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYOU PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-19",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "SPOONER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-602-8614",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominique Lynn Bastin
• Linda Larue Bates, RN
• Kimberly Batiste-Carrier
• Alexis Batiste
• Laurie M Baynard, DC
• Bayou Roots Integrated Care
• Dena Marie Bazzie, LPC LMFT
• Marcie Joanne Beamer
• Andrew Bearb, MD
• Dara Alyse Bearb, APRN-CNP

• Physical Therapist in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.