Individual provider Active NPI

Brooke Constant, PT, DPT

  • Physical Therapist
  • Prairieville, LA
National Provider Identifier
1306526801
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
09091 Issued in LA
Practice address
17135 Ronald Rd
Prairieville, LA 70769-4168
Phone
(225) 744-4878
NPI assigned
Jul 19, 2023
Last updated
Jul 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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 09091 LA Primary

Addresses

Primary practice location

17135 Ronald Rd
Prairieville, LA 70769-4168

Mailing address

17135 Ronald Rd
Prairieville, LA 70769-4168
Phone (225) 744-4878

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231204003043 LA Practitioner - Physical Therapist in Private Practice 5395193114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bourgeois Physical Therapy and Sports Rehab LLCGroup PAC ID 8820314115, 8 clinicians

Practice addresses (Care Compare)

2733 W Outfitters Dr
Gonzales, LA 70737-5155
Phone (225) 255-4040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09091LAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bourgeois Physical Therapy and Sports Rehab LLC Physical Therapist CurrentSince Sep 23, 2023 Accepting new patients

Locations

2733 W Outfitters Dr
Gonzales, LA 70737
Phone (225) 255-4040

17135 Ronald Rd
Prairieville, LA 70769
Phone (225) 744-4878

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, 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": "1689724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1306526801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17135 RONALD RD",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707694168",
            "telephone_number": "225-744-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17135 RONALD RD",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707694168",
            "telephone_number": "225-744-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSTANT",
        "first_name": "BROOKE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "09091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairieville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.