NPIMap

Organization Active NPI

Back in Motion Louisiana LLC

  • Physical Therapist
  • Mandeville, LA
National Provider Identifier
1285013573
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT04010 Issued in LA
Legal business name
BACK IN MOTION LOUISIANA LLC
Practice address
1414 N Causeway Blvd
Mandeville, LA 70471-3104
Phone
(941) 685-3665
NPI assigned
May 20, 2015
Last updated
Aug 26, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

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

Authorized official

Name
Timothy Eric Burnell, PT
Title
President
Phone
(941) 685-3665

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT04010 LA Primary

Addresses

Primary practice location

1414 N Causeway Blvd
Mandeville, LA 70471-3104

Mailing address

PO Box 894
Madisonville, LA 70447-0894
Phone (941) 685-3665

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440547200000",
    "number": "1285013573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 894",
            "city": "MADISONVILLE",
            "state": "LA",
            "postal_code": "704470894",
            "telephone_number": "941-685-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 N CAUSEWAY BLVD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713104",
            "telephone_number": "941-685-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK IN MOTION LOUISIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-20",
        "last_updated": "2015-08-26",
        "status": "A",
        "authorized_official_last_name": "BURNELL",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-685-3665",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "PT04010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; 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.