NPIMap

Organization Active NPI

Southern Orthopedics & Sports Therapy Inc

  • Physical Therapist
  • Houma, LA
National Provider Identifier
1104048321
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
03212 Issued in LA
Legal business name
SOUTHERN ORTHOPEDICS & SPORTS THERAPY INC
Practice address
1014 Belanger Street
Houma, LA 70360-4412
Phone
(985) 879-4388
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kinnard J Mark, LPT
Title
Office Manager
Phone
(985) 879-4388

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 03212 LA Primary

Addresses

Primary practice location

1014 Belanger Street
Houma, LA 70360-4412

Mailing address

1014 Belanger Street
Houma, LA 70360-4412
Phone (985) 879-4388

Other names 1

  • Houma Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

1014 Belanger St
Houma, LA 70360
Phone (985) 879-4388

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104048321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 BELANGER STREET",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703604412",
            "telephone_number": "985-879-4388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 BELANGER STREET",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703604412",
            "telephone_number": "985-879-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ORTHOPEDICS & SPORTS THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARK",
        "authorized_official_first_name": "KINNARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "985-879-4388",
        "authorized_official_credential": "LPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "03212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Houma Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houma, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.