Individual provider Active NPI

Douglas S Greenman, PT, DPT

  • Physical Therapist
  • Jennings, LA
National Provider Identifier
1164935318
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
09372 Issued in LA
Practice address
2002 Johnson St Ste 100
Jennings, LA 70546-3640
Phone
(337) 824-4547
Fax
(337) 824-4548
NPI assigned
Nov 9, 2017
Last updated
Jul 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 09372 LA Primary

Addresses

Primary practice location

2002 Johnson St Ste 100
Jennings, LA 70546-3640

Mailing address

PO Box 5083
Lake Charles, LA 70606-5083
Phone (337) 721-7280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171219001964 LA Practitioner - Physical Therapist in Private Practice 0042578155 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Rehab One, LLCGroup PAC ID 1557415114, 5 clinicians

Practice addresses (Care Compare)

1747 Imperial Blvd
Lake Charles, LA 70605-5362
Phone (337) 721-7280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09372LAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Center of Jefferson Davis Parish, Inc Physical Therapist CurrentSince Dec 1, 2017 Accepting new patients
Rehab One, LLC Physical Therapist CurrentSince Aug 15, 2022 Accepting new patients
Lemoine Therapy Services of Cenla Inc Physical Therapist PastSince Dec 1, 2017 Accepting new patients

Locations

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

1747 Imperial Blvd
Lake Charles, LA 70605
Phone (337) 721-7236

5150 Robotics Ln
Lake Charles, LA 70605
Phone (337) 214-1591

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1164935318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5083",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706065083",
            "telephone_number": "337-721-7280",
            "fax_number": "337-478-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENMAN",
        "first_name": "DOUGLAS",
        "middle_name": "S",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-09",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "09372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jennings, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.