Individual provider Active NPI

Coan Alan Knight, PT

  • Physical Therapist
  • Shreveport, LA
National Provider Identifier
1194970822
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1141950 Issued in TX
Practice address
8961 Youree Dr
Shreveport, LA 71115-3001
Phone
(318) 671-8772
Fax
(318) 671-8776
NPI assigned
Nov 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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 1141950 TX Primary

Addresses

Primary practice location

8961 Youree Dr
Shreveport, LA 71115-3001

Mailing address

402 Bethel Rd
Logansport, LA 71049-2318
Phone (318) 465-3391

Other practice location 1

463 Ashley Ridge Blvd Ste 100
Shreveport, LA 71106-7231
Phone (318) 671-8772

Other identifiers 1

IdentifierTypeStateIssuer
1976792MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190924001093 TX Practitioner - Physical Therapist in Private Practice 7315998002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Therapy and Balance Center, LLCGroup PAC ID 0345397899, 98 clinicians

Practice addresses (Care Compare)

204 Tenaha St
Center, TX 75935-3862
Phone (936) 280-0280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Therapy and Balance Center, LLC Physical Therapist CurrentSince Jan 15, 2008 Accepting new patients

Locations

463 Ashley Ridge Blvd
Ste 100
Shreveport, LA 71106
Phone (318) 221-3585

8961 Youree Dr
Shreveport, LA 71115
Phone (318) 671-8772

204 Tenaha St
Center, TX 75935
Phone (318) 465-3391

Organizations & group practices 1

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": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1194970822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 BETHEL RD",
            "city": "LOGANSPORT",
            "state": "LA",
            "postal_code": "710492318",
            "telephone_number": "318-465-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8961 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711153001",
            "telephone_number": "318-671-8772",
            "fax_number": "318-671-8776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "463 Ashley Ridge Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711067231",
            "country_code": "US",
            "telephone_number": "318-671-8772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNIGHT",
        "first_name": "COAN",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-21",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1141950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1976792",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; 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.