Active NPI
Francis Edmond St. Laurent, PTA
- Physical Therapy Assistant
- Kingman, AZ
National Provider Identifier
1245480938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 6513A
- 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
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 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
| License | State | Type | Specialty |
|---|---|---|---|
| 6513A | AZ | MD | Physical 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.