Individual provider Active NPI

Katherine Claire Prevost, DPT

  • Physical Therapist
  • Lake Charles, LA
National Provider Identifier
1124308234
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
07815 Issued in LA
Practice address
4141 Common St
Lake Charles, LA 70607-4501
Phone
(337) 990-5621
Fax
(337) 990-5623
NPI assigned
Aug 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 07815 LA Primary

Addresses

Primary practice location

4141 Common St
Lake Charles, LA 70607-4501

Mailing address

4150 Nelson Rd
Suite C12
Lake Charles, LA 70605-4148
Phone (337) 990-5621

Other practice location 1

502 N Parkerson Ave
Crowley, LA 70526-4351
Phone (337) 990-5621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120116000135 LA Practitioner - Physical Therapist in Private Practice 5991972929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Louisiana State University School of Medicine in Shreveport, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Physical Therapy, Inc.Group PAC ID 4385894104, 10 clinicians

Practice addresses (Care Compare)

300 E McNeese St
Suite 104 Thrive Pelvic Floor and Pregnancy C
Lake Charles, LA 70605-5700
Phone (337) 990-5622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Physical Therapy, Inc. Physical Therapist CurrentSince Sep 16, 2012 Accepting new patients
Lemoine Therapy Services of Cenla Inc Physical Therapist Past Accepting new patients

Locations

502 N Parkerson Ave
Crowley, LA 70526
Phone (337) 990-5621

4150 Nelson Rd
Ste C12
Lake Charles, LA 70605
Phone (337) 990-5621

300 E McNeese St
Ste 104
Lake Charles, LA 70605
Phone (337) 990-5621

4141 Common St
Lake Charles, LA 70607
Phone (337) 990-5621

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6743/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1124308234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 NELSON RD",
            "address_2": "SUITE C12",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054148",
            "telephone_number": "337-990-5621",
            "fax_number": "337-990-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 COMMON ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706074501",
            "telephone_number": "337-990-5621",
            "fax_number": "337-990-5623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 N Parkerson Ave",
            "address_purpose": "LOCATION",
            "city": "Crowley",
            "state": "LA",
            "postal_code": "705264351",
            "country_code": "US",
            "telephone_number": "337-990-5621",
            "fax_number": "337-990-5623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PREVOST",
        "first_name": "KATHERINE",
        "middle_name": "CLAIRE",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "07815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.