Prism II, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PRISM II, LLC

Practice address

740 Keyser Ave
Natchitoches, LA 71457-6037

Phone

(318) 214-0088

Fax

(318) 214-9009

NPI assigned

Mar 15, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Joe Bienvenu, OTNPI 1477705556

Title

Partner

Phone

(318) 481-2148

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 7

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

• Joe F Bienvenu, O.T.

  • Occupational Therapist
  • Natchitoches, LA
  • NPI 1477705556
  Medicare reassignment Care Compare group NPD Authorized official
• Richard L Guidroz, PT

  • Physical Therapist
  • Natchitoches, LA
  • NPI 1386700102
  Medicare reassignment Care Compare group NPD
• Warren J Weber, PT

  • Physical Therapist
  • Jonesboro, LA
  • NPI 1063694511
  Medicare reassignment Care Compare group NPD
• Charles Garrett Anderson

  • Occupational Therapist
  • Natchitoches, LA
  • NPI 1851410781
  NPD (past)
• Chelsa Gene'T Fontenot, M.S., A.T.C., L.A.T.

  • Athletic Trainer
  • Natchitoches, LA
  • NPI 1952509275
  NPD (past)
• Trenton B Shepherd, PT

  • Physical Therapist
  • Shreveport, LA
  • NPI 1093043622
  NPD (past)
• Bethany Troquille, SLP

  • Speech-Language Pathologist
  • Natchitoches, LA
  • NPI 1831446368
  NPD (past)

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268611200000",
    "number": "1104140565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 KEYSER AVE",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714576037",
            "telephone_number": "318-214-0088",
            "fax_number": "318-214-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 KEYSER AVE",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714576037",
            "telephone_number": "318-214-0088",
            "fax_number": "318-214-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISM II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-15",
        "last_updated": "2010-03-15",
        "status": "A",
        "authorized_official_last_name": "BIENVENU",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "318-481-2148",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1362630",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1524069",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harvey R Polk, CAC
• Connie Porter
• Lauren Kay Potts
• Vicki Powell
• Emiley Paige Pratt, FNP-C
• Provision Rehab
• Provision Rehab, LLC
• Psychological Consulting
• Quest Diagnostics Clinical Laboratories Inc
• Randall Keator, II, O.D., LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.