Individual provider Active NPI

Meliva Suico, PHYSICAL THERAPIST

  • Physical Therapist
  • Baton Rouge, LA
National Provider Identifier
1285694273
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
01081F Issued in LA
Practice address
11281 Old Hammond Hwy
Building a
Baton Rouge, LA 70816-8404
Phone
(225) 275-3177
Fax
(225) 275-0922
NPI assigned
Mar 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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 01081F LA Primary

Addresses

Primary practice location

11281 Old Hammond Hwy
Building a
Baton Rouge, LA 70816-8404

Mailing address

841 Troutbeck Dr
Baton Rouge, LA 70810-1993
Phone (225) 275-3177

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

State licenses

LicenseStateTypeSpecialty
01081FLAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Masters Physical Therapist PastSince May 20, 2006 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216166400000",
    "number": "1285694273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 TROUTBECK DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708101993",
            "telephone_number": "225-275-3177",
            "fax_number": "225-275-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11281 OLD HAMMOND HWY",
            "address_2": "BUILDING A",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708168404",
            "telephone_number": "225-275-3177",
            "fax_number": "225-275-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUICO",
        "first_name": "MELIVA",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2008-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "01081F",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.

Verify at the official NPI Registry.