Individual provider Active NPI

Francis Edmond St. Laurent, PTA

  • Physical Therapy Assistant
  • Kingman, AZ
National Provider Identifier
1245480938
Registry record updated Sep 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
6513A Issued in AZ
Practice address
2505 Hualapai MTN Rd. Ste E
Lifefitrehab
Kingman, AZ 86401
Phone
(877) 718-4301
Fax
(928) 718-4303
NPI assigned
Sep 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 6513A AZ Primary

Addresses

Primary practice location

2505 Hualapai MTN Rd. Ste E
Lifefitrehab
Kingman, AZ 86401

Mailing address

16565 N Lariat Dr
Dolan Springs, AZ 86441-9714
Phone (802) 683-9914

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6513AAZMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222732800000",
    "number": "1245480938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16565 N LARIAT DR",
            "city": "DOLAN SPRINGS",
            "state": "AZ",
            "postal_code": "864419714",
            "telephone_number": "802-683-9914",
            "fax_number": "928-767-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 HUALAPAI MTN RD. STE E",
            "address_2": "LIFEFITREHAB",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "86401",
            "telephone_number": "877-718-4301",
            "fax_number": "928-718-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. LAURENT",
        "first_name": "FRANCIS",
        "middle_name": "EDMOND",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-30",
        "last_updated": "2008-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "6513A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.