Function First Physical Therapy, LLC

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

08117 Issued in LA

Legal business name

FUNCTION FIRST PHYSICAL THERAPY, LLC

Practice address

7607 Fern Ave Ste 704
Shreveport, LA 71105-5744

Phone

(318) 828-1450

Fax

(318) 828-2697

NPI assigned

Nov 13, 2017

Last updated

Jul 15, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gregory Kyle Kintzing, DPTNPI 1316303399

Title

Ceo

Phone

(318) 828-1450

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gregory Kyle Kintzing, DPT

  • Physical Therapist
  • Shreveport, LA
  • NPI 1316303399
  Medicare reassignment Care Compare group NPD Authorized official
• Morgan Alford

  • Physical Therapist
  • Shreveport, LA
  • NPI 1659943801
  Medicare reassignment Care Compare group NPD
• Tara Lindsey Barnes, OTR

  • Occupational Therapist
  • Shreveport, LA
  • NPI 1629250824
  Medicare reassignment Care Compare group NPD
• Jordan Benson, OTR

  • Occupational Therapist
  • Shreveport, LA
  • NPI 1457221467
  Medicare reassignment Care Compare group NPD
• Ernest Carpenter III, LOTR

  • Occupational Therapist
  • Shreveport, LA
  • NPI 1235636226
  Medicare reassignment Care Compare group NPD
• Alissa Diaz, MOT/LOTR

  • Occupational Therapist
  • Shreveport, LA
  • NPI 1124992383
  Medicare reassignment Care Compare group NPD
• Jill Frost, MCD, CCC/SLP

  • Speech-Language Pathologist
  • Bossier City, LA
  • NPI 1710587886
  Medicare reassignment Care Compare group NPD
• Krisha Andrea Holland, DPT

  • Physical Therapist
  • Shreveport, LA
  • NPI 1043903834
  Medicare reassignment Care Compare group NPD
• John Nikko Williams, DPT

  • Physical Therapist
  • Shreveport, LA
  • NPI 1366163214

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Sydney Williams

  • Physical Therapist
  • Shreveport, LA
  • NPI 1013537943
  Medicare reassignment Care Compare group NPD
• Keith Calvin Crnkovic, DPT

  • Physical Therapist
  • Bossier City, LA
  • NPI 1528684891
  Medicare reassignment NPD
• Denise Rae Gerrity, DPT

  • Physical Therapist
  • Shreveport, LA
  • NPI 1346826393
  Medicare reassignment NPD

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1114430071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7607 FERN AVE STE 704",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055744",
            "telephone_number": "318-828-1450",
            "fax_number": "318-828-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7607 FERN AVE STE 704",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055744",
            "telephone_number": "318-828-1450",
            "fax_number": "318-828-2697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2122 Airline Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Bossier City",
            "state": "LA",
            "postal_code": "711113270",
            "country_code": "US",
            "telephone_number": "318-828-1450",
            "fax_number": "318-828-2697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FUNCTION FIRST PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-13",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "KINTZING",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-828-1450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "08117",
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": "LA",
            "license": "08117",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taneka M Fuller, LPC
• Albert Fullwood Sr.
• Marcus Jevon Fulton, NREMT-B
• Fultz Physical Therapy and Joint Rehab, LLC
• Christopher Fultz, DPT
• Jacob Wade Funderburk, PLPC
• Dannette Furgerson, AGPCNP
• Ansley Fussell, MOT
• Zachary Blake Fussell, MSN, APRN, PMHNP-BC
• Michael Futrell, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.