Stephen Todd Zachary, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

09079R Issued in LA

Practice address

4615 Highway 80 Ste 9
Haughton, LA 71037-7480

Phone

(318) 615-3003

NPI assigned

May 9, 2018

Last updated

May 9, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Benton Physical Therapy, LLCGroup PAC ID 2769740737, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Benton Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Benton, LA
  • NPI 1972013969
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525824000000",
    "number": "1114416732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3203 HANOVER CT",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711118167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 HIGHWAY 80 STE 9",
            "city": "HAUGHTON",
            "state": "LA",
            "postal_code": "710377480",
            "telephone_number": "318-615-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHARY",
        "first_name": "STEPHEN",
        "middle_name": "TODD",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "LA",
            "license": "09079R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanisha Sharda White
• Jared Williams, ATC, NASM-PES
• Andreka Winston
• Carolyn B Yates, PHARM D
• Alexis Youngblood

• Physical Medicine & Rehabilitation Physician in Haughton, LA
• Providers in Haughton, LA by specialty
• Physical Medicine & Rehabilitation Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.