NPIMap

Organization Active NPI

Synergy Care Southeast LLC

Doing business as Synergy Care Southeast LLC - Georgia

  • Physical Therapist
  • Lake Charles, LA
National Provider Identifier
1073852075
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SYNERGY CARE SOUTHEAST LLC
Doing business as
Synergy Care Southeast LLC - Georgia
Practice address
127 W Broad St
Lake Charles, LA 70601-4291
Phone
(337) 310-8500
Fax
(888) 241-3028
NPI assigned
Feb 11, 2013
Last updated
Jul 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Authorized official

Name
Mr. Todd Broussard
Title
Controller
Phone
(337) 310-8500

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

127 W Broad St
Lake Charles, LA 70601-4291

Mailing address

127 W Broad St
Lake Charles, LA 70601-4291
Phone (337) 310-8500

Other names 1

  • Synergy Care Southeast LLC - Georgia Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1360540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374710400000",
    "number": "1073852075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 W BROAD ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706014291",
            "telephone_number": "337-310-8500",
            "fax_number": "888-241-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 W BROAD ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706014291",
            "telephone_number": "337-310-8500",
            "fax_number": "888-241-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY CARE SOUTHEAST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-11",
        "last_updated": "2013-07-25",
        "status": "A",
        "authorized_official_last_name": "BROUSSARD",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "337-310-8500",
        "authorized_official_name_prefix": "Mr."
    },
    "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
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Synergy Care Southeast LLC - Georgia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; 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.