NPIMap

Organization Active NPI

Southern Rehab Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Belle Chasse, LA
National Provider Identifier
1144640442
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
08652 Issued in LA
Legal business name
SOUTHERN REHAB PHYSICAL THERAPY LLC
Practice address
900 Woodland Hwy
Belle Chasse, LA 70037-1633
Phone
(504) 628-8085
NPI assigned
Apr 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Authorized official

Name
Dr. Brent M Robertson, P.T.NPI 1699194647
Title
Officer/ Agent / Physical Therapist
Phone
(504) 628-8085

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 08652 LA Primary

Addresses

Primary practice location

900 Woodland Hwy
Belle Chasse, LA 70037-1633

Mailing address

900 Woodland Hwy
Belle Chasse, LA 70037-1633

Other names 1

  • Southern Rehab Other name

National Provider Directory

National Provider Directory

Locations

900 Woodland Hwy
Belle Chasse, LA 70037
Phone (504) 628-8085

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399852800000",
    "number": "1144640442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WOODLAND HWY",
            "city": "BELLE CHASSE",
            "state": "LA",
            "postal_code": "700371633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WOODLAND HWY",
            "city": "BELLE CHASSE",
            "state": "LA",
            "postal_code": "700371633",
            "telephone_number": "504-628-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN REHAB PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-24",
        "last_updated": "2014-05-12",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICER/ AGENT / PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "504-628-8085",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "LA",
            "license": "08652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Rehab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Belle Chasse, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; 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.