Individual provider Active NPI

Emma Granger

  • Physical Therapist
  • Abbeville, LA
National Provider Identifier
1285012195
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
08860 Issued in LA
Practice address
19103 Theall Rd
Abbeville, LA 70510-0205
Phone
(337) 893-1602
NPI assigned
May 12, 2015
Last updated
May 12, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 08860 LA Primary

Addresses

Primary practice location

19103 Theall Rd
Abbeville, LA 70510-0205

Mailing address

19103 Theall Rd
Abbeville, LA 70510-0205

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181011000417 LA Practitioner - Physical Therapist in Private Practice 6406108901 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri City Physical Therapy, Inc.Group PAC ID 3870485030, 5 clinicians

Practice addresses (Care Compare)

233 Doucet Rd
Suite B2
Lafayette, LA 70503-3403
Phone (337) 991-9972

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08860LAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
River Region Rehab, LLC Physical Therapist CurrentSince Sep 25, 2018 Accepting new patients
Tri City Physical Therapy, Inc. Physical Therapist CurrentSince Oct 2, 2019 Accepting new patients
St. Bernard Physical Therapy Clinic, Inc. Physical Therapist PastSince Sep 25, 2018 Accepting new patients
Northern Lights Physical Therapy, LLC Physical Therapist PastSince Jun 1, 2019 Accepting new patients

Locations

233 Doucet Rd
Ste B2
Lafayette, LA 70503
Phone (337) 991-9972

6772 Johnston St
Unit 1300
Lafayette, LA 70503
Phone (337) 534-8052

12371 Highway 90
Ste D
Luling, LA 70070
Phone (985) 331-1001

10001 Lake Forest Blvd
Ste 102
New Orleans, LA 70127
Phone (504) 281-4521

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1285012195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19103 THEALL RD",
            "city": "ABBEVILLE",
            "state": "LA",
            "postal_code": "705100205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19103 THEALL RD",
            "city": "ABBEVILLE",
            "state": "LA",
            "postal_code": "705100205",
            "telephone_number": "337-893-1602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "EMMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-12",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "08860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abbeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.