Active NPI
Lane Taylor Macdougall, DPT
- Physical Therapist
- Marrero, LA
National Provider Identifier
1154977643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10345
- Practice address
- 1111 Medical Center Blvd Ste 630
Marrero, LA 70072-3194 - Phone
- (504) 340-6976
- NPI assigned
- Aug 12, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10345 | LA | Primary |
Addresses
Primary practice location
1111 Medical Center Blvd Ste 630
Marrero, LA 70072-3194
Mailing address
1111 Medical Center Blvd Ste 630
Marrero, LA 70072-3194
Phone (504) 340-6976
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565568000000",
"number": "1154977643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 MEDICAL CENTER BLVD STE 630",
"city": "MARRERO",
"state": "LA",
"postal_code": "700723194",
"telephone_number": "504-340-6976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 MEDICAL CENTER BLVD STE 630",
"city": "MARRERO",
"state": "LA",
"postal_code": "700723194",
"telephone_number": "504-340-6976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACDOUGALL",
"first_name": "LANE",
"middle_name": "TAYLOR",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-12",
"last_updated": "2019-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "10345",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marrero, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.