NPIMap

Organization Active NPI

Amite Physical Therapy Inc

Doing business as Professional Physical Therapy

  • Specialist
  • Amite, LA
National Provider Identifier
1265589451
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
140 Issued in LA
Legal business name
AMITE PHYSICAL THERAPY INC
Doing business as
Professional Physical Therapy
Practice address
216 N 2ND St
Amite, LA 70422-2408
Phone
(985) 748-7878
Fax
(985) 748-2837
NPI assigned
Jan 3, 2007
Last updated
Jun 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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

Authorized official

Name
Prof. Marvin Bruce Neal Jr., P.T.NPI 1003885310
Title
President
Phone
(985) 748-7878

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 140 LA Primary

Addresses

Primary practice location

216 N 2ND St
Amite, LA 70422-2408

Mailing address

PO Box 398
Amite, LA 70422-0398
Phone (985) 748-7878

Other names 1

  • PROFESSIONAL PHYSICAL THERAPY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050419000004 LA Part B Supplier - Clinic/Group Practice 5092753327 Receives reassigned benefits from 7 practitioners
Practice locations: Amite, LA

National Provider Directory

National Provider Directory
Tax ID family
Amite Physical Therapy Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

216 N 2nd St
Amite, LA 70422
Phone (504) 748-7878

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307318400000",
    "number": "1265589451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 398",
            "city": "AMITE",
            "state": "LA",
            "postal_code": "704220398",
            "telephone_number": "985-748-7878",
            "fax_number": "985-748-2837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 N 2ND ST",
            "city": "AMITE",
            "state": "LA",
            "postal_code": "704222408",
            "telephone_number": "985-748-7878",
            "fax_number": "985-748-2837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMITE PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2011-06-06",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "985-748-7878",
        "authorized_official_name_prefix": "Prof.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROFESSIONAL PHYSICAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Amite, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.