Individual provider Active NPI

Jennifer J White, PTA

  • Physical Therapy Assistant
  • Alexandria, LA
National Provider Identifier
1164077764
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A8497 Issued in LA
Practice address
4501 Jackson St Ste B
Alexandria, LA 71303-2555
Phone
(318) 704-0710
Fax
(318) 704-0711
NPI assigned
Aug 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A8497 LA Primary

Addresses

Primary practice location

4501 Jackson St Ste B
Alexandria, LA 71303-2555

Mailing address

2002 Johnson St Ste 100
Jennings, LA 70546-3640
Phone (337) 824-4547

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A8497LAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lemoine Therapy Services of Cenla Inc CurrentSince Aug 11, 2019 Accepting new patients
Therapy Center of Jefferson Davis Parish, Inc Physical Therapy Assistant CurrentSince Aug 11, 2019 Accepting new patients

Locations

4501 Jackson Street Ext
Ste B
Alexandria, LA 71303
Phone (318) 240-7680

2002 Johnson St
Ste 100
Jennings, LA 70546
Phone (337) 824-8287

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": "1565308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1164077764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 JOHNSON ST STE 100",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463640",
            "telephone_number": "337-824-4547",
            "fax_number": "337-824-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 JACKSON ST STE B",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032555",
            "telephone_number": "318-704-0710",
            "fax_number": "318-704-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JENNIFER",
        "middle_name": "J",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-09",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "LA",
            "license": "A8497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.

Verify at the official NPI Registry.