Active NPI
Kelly Daniels, PT, DPT
- Orthopedic Physical Therapist
- Shreveport, LA
National Provider Identifier
1093131765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 08479
- Practice address
- 1500 Line Ave
Shreveport, LA 71101-4639 - Phone
- (318) 213-3810
- NPI assigned
- Mar 5, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 08479 | LA | Primary |
Addresses
Primary practice location
1500 Line Ave
Shreveport, LA 71101-4639
Mailing address
5400 Barksdale Blvd
Apt 412
Bossier City, LA 71112-4538
Phone (318) 560-6192
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 |
|---|---|---|---|
| 08479 | LA | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393977600000",
"number": "1093131765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5400 BARKSDALE BLVD",
"address_2": "APT 412",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711124538",
"telephone_number": "318-560-6192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 LINE AVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711014639",
"telephone_number": "318-213-3810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIELS",
"first_name": "KELLY",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-05",
"last_updated": "2014-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "LA",
"license": "08479",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.