PG Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PG THERAPY LLC

Practice address

16172 Airline Hwy Ste B
Prairieville, LA 70769-4212

Phone

(225) 255-4020

Fax

(225) 255-4024

NPI assigned

May 26, 2022

Organization subpart

Yes

Parent organization

PERSEVERE CORPAs reported in NPPES

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

Addresses

Other identifiers 4

Other names 1

• FYZICAL Therapy & Balance Centers Doing business as

Locations

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "5281",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "8819519",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEOPLESHEALTH",
            "identifier": "100125742",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE (OPTUM)",
            "identifier": "187466",
            "state": null
        }
    ],
    "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"
        }
    ]
}

• Perkins Surgical Assist II, L.L.C.
• Penny Leone Perkins, FNP-BC, FNP-C
• Thomas Perkins, M.D.
• Patricia Moncada Pertuit, RN
• Megan Rose Petty
• Caotuan Pham, PHARMD
• Albert Pickett, D.P.T.
• Melanie Pierre
• Aimee Pike, LOTR
• Cori Planchard

• All providers in Prairieville, LA
• Physical Therapy Clinic/Center in Louisiana

• 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.

Verify at the official NPI Registry.