Individual provider Active NPI

Danielle H Imarata, DPT

  • Physical Therapist
  • Zachary, LA
National Provider Identifier
1215411210
Registry record updated Sep 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10114 Issued in LA
Practice address
1326 Church St
Zachary, LA 70791-2743
Phone
(225) 654-8208
Fax
(225) 654-4642
NPI assigned
Sep 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2018

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 10114 LA Primary

Addresses

Primary practice location

1326 Church St
Zachary, LA 70791-2743

Mailing address

1326 Church St
Zachary, LA 70791-2743
Phone (225) 654-8208

Other identifiers 1

IdentifierTypeStateIssuer
10114OtherLALICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181126001779 LA Practitioner - Physical Therapist in Private Practice 3577817816 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Innovations in Evaluative Medicine LLCGroup PAC ID 5395981427, 7 clinicians

Practice addresses (Care Compare)

9373 Baringer Foreman Rd
BLDG 2
Baton Rouge, LA 70817-6200
Phone (225) 304-4749

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10114LAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Alvin C Moreau Jr Licensed Physical Therapist DTD 01 15 82 Physical Therapist CurrentSince Oct 31, 2018 Accepting new patients
Center for Innovations in Evaluative Medicine, LLC CurrentSince Oct 31, 2018 Accepting new patients
Moreau Physical Therapy Inc. Physical Therapist CurrentSince Oct 31, 2018 Accepting new patients

Locations

9373 Baringer Foreman Rd
Bldg 2
Baton Rouge, LA 70817
Phone (225) 304-4749

11424 Sullivan Rd
#A-C
Baton Rouge, LA 70818
Phone (225) 261-7021

18161 E Petroleum Dr
Baton Rouge, LA 70809
Phone (225) 751-8512

4324 S Sherwood Frst
Ste B170
Baton Rouge, LA 70816

1326 Church St
Zachary, LA 70791
Phone 2256548208 ext. 1160

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537142400000",
    "number": "1215411210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 CHURCH ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707912743",
            "telephone_number": "225-654-8208",
            "fax_number": "225-654-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1326 CHURCH ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707912743",
            "telephone_number": "225-654-8208",
            "fax_number": "225-654-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMARATA",
        "first_name": "DANIELLE",
        "middle_name": "H",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-17",
        "last_updated": "2018-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "10114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "10114",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zachary, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2018; 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.