Active NPI
Tyler Gregory Lusignan, PT
- Physical Therapist
- Jefferson, LA
National Provider Identifier
1225511462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 09976
- Practice address
- 101 River Rd Ste 112
Jefferson, LA 70121-4226 - Phone
- (504) 828-7696
- Fax
- (504) 828-8935
- NPI assigned
- Sep 13, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 09976 | LA | Primary |
Addresses
Primary practice location
101 River Rd Ste 112
Jefferson, LA 70121-4226
Mailing address
101 River Rd Ste 112
Jefferson, LA 70121-4226
Phone (504) 828-7696
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09976 | LA | MD | Physical Therapist |
Interoperability endpoints
- tyler.lusignan@811393367080964.direct.elationemr.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536796800000",
"number": "1225511462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 RIVER RD STE 112",
"city": "JEFFERSON",
"state": "LA",
"postal_code": "701214226",
"telephone_number": "504-828-7696",
"fax_number": "504-828-8935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 RIVER RD STE 112",
"city": "JEFFERSON",
"state": "LA",
"postal_code": "701214226",
"telephone_number": "504-828-7696",
"fax_number": "504-828-8935"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUSIGNAN",
"first_name": "TYLER",
"middle_name": "GREGORY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-13",
"last_updated": "2018-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "09976",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jefferson, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.