Active NPI
PG Therapy LLC
Doing business as FYZICAL Therapy & Balance Centers
- Physical Therapy Clinic/Center
- Prairieville, LA
National Provider Identifier
1134867203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- Legal business name
- PG THERAPY LLC
- Doing business as
- FYZICAL Therapy & Balance Centers
- Practice address
- 16172 Airline Hwy Ste B
Prairieville, LA 70769-4212 - Phone
- (225) 255-4020
- Fax
- (225) 255-4024
- NPI assigned
- May 26, 2022
- Last updated
- May 2, 2023
- Organization subpart
- Yes
- Parent organization
- PERSEVERE CORP
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Patrick John Gleeson, CISSP
- Title
- General Manager
- Phone
- (202) 455-6605
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | Primary |
Addresses
Primary practice location
16172 Airline Hwy Ste B
Prairieville, LA 70769-4212
Mailing address
9029 Jefferson Hwy Ste D-104
New Orleans, LA 70123-3500
Phone (225) 255-4020
Other names 1
- FYZICAL Therapy & Balance Centers
National Provider Directory
National Provider DirectoryLocations
9029 Jefferson Hwy
Ste D104
New Orleans, LA 70123
9029 Jefferson Hwy
Ste D1043
New Orleans, LA 70123
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653523200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1682985600000",
"number": "1134867203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9029 JEFFERSON HWY STE D-104",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701233500",
"telephone_number": "225-255-4020",
"fax_number": "225-255-4024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16172 AIRLINE HWY STE B",
"city": "PRAIRIEVILLE",
"state": "LA",
"postal_code": "707694212",
"telephone_number": "225-255-4020",
"fax_number": "225-255-4024"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PG THERAPY LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PERSEVERE CORP",
"enumeration_date": "2022-05-26",
"last_updated": "2023-05-02",
"certification_date": "2023-05-02",
"status": "A",
"authorized_official_last_name": "GLEESON",
"authorized_official_first_name": "PATRICK",
"authorized_official_middle_name": "JOHN",
"authorized_official_title_or_position": "GENERAL MANAGER",
"authorized_official_telephone_number": "202-455-6605",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "CISSP"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "FYZICAL Therapy & Balance Centers",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "FYZICAL Therapy & Balance Centers",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Prairieville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.