MC2 Enterprises, LLC

Primary specialty

Child Physical Disabilities Respite CareTaxonomy code 385HR2065X

Legal business name

MC2 ENTERPRISES, LLC

Doing business as

Go Physical Therapy

Practice address

4715 Perkins Rd
Baton Rouge, LA 70808-3040

Phone

(225) 923-0110

Fax

(225) 923-0111

NPI assigned

Mar 1, 2007

Last updated

Dec 27, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gloria Wall, P.T.NPI 1194901439

Title

Owner

Phone

(225) 923-0110

Specialties & licenses 1

Addresses

Other names 1

• Go Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Tax ID family

MC2 Enterprises LLC3 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.

• MC2 Enterprises, LLC

  dba Go Physical Therapy - Manship

  • Physical Therapy Clinic/Center
  • Baton Rouge, LA
  • NPI 1326360074
  NPD tax ID
• MC2 Enterprises, LLC

  dba Go Physical Therapy- S. Foster

  • Physical Therapy Clinic/Center
  • Baton Rouge, LA
  • NPI 1982830337
  NPD tax ID

Locations

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• MC2 Enterprises, LLC

  dba Go Physical Therapy - Manship

  • Physical Therapy Clinic/Center
  • Baton Rouge, LA
  • NPI 1326360074
  NPPES parent name
• MC2 Enterprises, LLC

  dba Go Physical Therapy- S. Foster

  • Physical Therapy Clinic/Center
  • Baton Rouge, LA
  • NPI 1982830337
  NPPES parent name

Practitioners 6

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.

• Gloria L Wall, P.T.

  • Physical Therapist
  • Baton Rouge, LA
  • NPI 1194901439
  Medicare reassignment Care Compare group NPD Authorized official
• Tejas N Vora, DPT

  • Physical Therapist
  • Walker, LA
  • NPI 1326131848
  Medicare reassignment Care Compare group NPD
• Vicki Eshpeter, PTA

  • Physical Therapy Assistant
  • Baton Rouge, LA
  • NPI 1447104690
  NPD (past)
• Marla Marie Jordan

  • Physical Therapist
  • Baton Rouge, LA
  • NPI 1811242258
  NPD (past)
• Patrick E Obrien, PT

  • Physical Therapist
  • Baton Rouge, LA
  • NPI 1942435359
  NPD (past)
• Kayla Darsam Butler

  • Physical Therapy Assistant
  • Laguna Hills, CA
  • NPI 1013764133
  NPD (past)

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198713600000",
    "number": "1326176629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4715 PERKINS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708083040",
            "telephone_number": "225-923-0110",
            "fax_number": "225-923-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4715 PERKINS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708083040",
            "telephone_number": "225-923-0110",
            "fax_number": "225-923-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MC2 ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-12-27",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-923-0110",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Go Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marlon Patrick Mazant Sr., PHARMD
• Mathew J. Mazoch, MD
• Mary Beth Mazza-Ricketts, APRN
• Edith Mbagwu, M.D.
• Zuhura Mbengwa
• MC2 Enterprises, LLC (Go Physical Therapy - Manship)
• MC2 Enterprises, LLC (Go Physical Therapy- S. Foster)
• Becki Ellender McAlister, NP
• Frankie McArthur
• Veronica McArthur

• Respite Care in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Respite Care in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; 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.