Image Physical Therapy Center LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

01833F Issued in LA

Legal business name

IMAGE PHYSICAL THERAPY CENTER LLC

Practice address

3021 Verot School Rd
Lafayette, LA 70508

Phone

(337) 857-6178

Fax

(337) 857-6592

NPI assigned

Jan 30, 2007

Last updated

May 2, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Boitumelo P Kgoadi, PHYSICAL THERAPISTNPI 1740375955

Title

Physical Therapist

Phone

(337) 857-6178

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Boitumelo Pelokgale Kgoadi, RPT

  • Specialist
  • Lafayette, LA
  • NPI 1740375955
  NPD (past) Authorized official
• Micah Bradley Harriss, P.T.

  • Physical Therapist
  • Lafayette, LA
  • NPI 1265518344
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209686400000",
    "number": "1184760498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3527 AMBASSADOR CAFFERY PKWY # 13",
            "address_2": "BOX 13",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705035130",
            "telephone_number": "337-857-6178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 VEROT SCHOOL RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70508",
            "telephone_number": "337-857-6178",
            "fax_number": "337-857-6592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGE PHYSICAL THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2008-05-02",
        "status": "A",
        "authorized_official_last_name": "KGOADI",
        "authorized_official_first_name": "BOITUMELO",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "337-857-6178",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "LA",
            "license": "01833F",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ikigai Health Solutions LLC (The Ohana Clinic)
• Jessie Iles, FNP-C, PMHNP-BC
• Ilyas Munshi, M.D.
• Ilyas Munshi, MD Apmc (Ilyas Munshi, MD)
• Imagdent Acadiana, L.L.C.
• Imaging Resources of Louisiana, LLC
• Imaging Services of Louisiana LLC (dba Women's Imaging Centre-Lafayette)
• Imaging Services of Louisiana LLC (Elaine M Junca Women's Imaging Center)
• Impac (I.M.P.A.C. by Alternative Home Care Specialists, Inc.)
• Impact Living Care LLC

• Physical Therapy Clinic/Center in Lafayette, LA
• Providers in Lafayette, LA by specialty
• 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, 2008; 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.