BMMG, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

08831R Issued in TX

Legal business name

BMMG, LLC

Practice address

6030 Line Ave
Shreveport, LA 71106-2062

Phone

(318) 742-3408

NPI assigned

Nov 20, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Matthew Franz St. Amant

Title

Member

Phone

(318) 742-3408

Specialties & licenses 1

Addresses

Other names 1

• CryoSpa Doing business as

Locations

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447977600000",
    "number": "1083088520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 BENTON RD",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711113744",
            "telephone_number": "318-747-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6030 LINE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711062062",
            "telephone_number": "318-742-3408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BMMG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-20",
        "last_updated": "2015-11-20",
        "status": "A",
        "authorized_official_last_name": "ST. AMANT",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "FRANZ",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "318-742-3408",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "08831R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CryoSpa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Corsica Blow
• Blue Street Transportation, LLC
• Bluefin Medical, LLC
• Stuart Louis Blum, MD
• Jenna Nicole Blundell, FNP
• Bno Surgical Consultants, LLC
• Elena Boardman
• Ebony Bobb-Semple
• Joseph Anthony Bocchini Jr., M.D.
• Nta Opeoluwa Boco, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.