Active NPI
Sidney Borne
- Physical Therapist
- Slidell, LA
National Provider Identifier
1255448734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 2132 Gause Blvd E
Ste 6
Slidell, LA 70461-4243 - Phone
- (985) 646-2531
- NPI assigned
- Aug 23, 2006
- 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 | Primary |
Addresses
Primary practice location
2132 Gause Blvd E
Ste 6
Slidell, LA 70461-4243
Mailing address
1190 Waguespack St
Vacherie, LA 70090-5300
Phone (504) 818-1173
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05171 | Other | LA | LICENSE # |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255448734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1190 WAGUESPACK ST",
"city": "VACHERIE",
"state": "LA",
"postal_code": "700905300",
"telephone_number": "504-818-1173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2132 GAUSE BLVD E",
"address_2": "STE 6",
"city": "SLIDELL",
"state": "LA",
"postal_code": "704614243",
"telephone_number": "985-646-2531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORNE",
"first_name": "SIDNEY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "05171",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Slidell, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.