Individual provider Active NPI

Lindsay Randazzo Kelly, DPT

  • Physical Therapist
  • Metairie, LA
National Provider Identifier
1215282199
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
08384 Issued in LA
Practice address
3939 Houma Blvd
#17
Metairie, LA 70006-2931
Phone
(504) 885-9121
NPI assigned
Jul 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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 08384 LA Primary

Addresses

Primary practice location

3939 Houma Blvd
#17
Metairie, LA 70006-2931

Mailing address

3939 Houma Blvd
#17
Metairie, LA 70006-2931
Phone (504) 885-9121

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121005000038 LA Practitioner - Physical Therapist in Private Practice 7113176223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverbend Physical Therapy LLCGroup PAC ID 3173885472, 9 clinicians

Practice addresses (Care Compare)

2033 N Hwy 190
Covington, LA 70433-8985
Phone (504) 603-6044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Physical Therapy, LLC Physical Therapist CurrentSince Feb 27, 2018 Accepting new patients
Rehab Access LLC Physical Therapist Past Accepting new patients

Locations

900 Woodland Hwy
Ste 201
Belle Chasse, LA 70037

70493 Highway 21
Ste 600
Covington, LA 70433
Phone (985) 317-3335

15835 De Marco Ln
Hammond, LA 70403
Phone (504) 603-6044

3409 Division St
Ste 202
Metairie, LA 70002
Phone (504) 603-6044

9605 Jefferson Hwy
Ste I
River Ridge, LA 70123
Phone (504) 603-6044

9605 Jefferson Hwy
Ste 1
River Ridge, LA 70123

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": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1215282199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 HOUMA BLVD",
            "address_2": "#17",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062931",
            "telephone_number": "504-885-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 HOUMA BLVD",
            "address_2": "#17",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062931",
            "telephone_number": "504-885-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LINDSAY",
        "middle_name": "RANDAZZO",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "08384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; 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.