Geaux Fit of la LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

07456 Issued in LA

Legal business name

GEAUX FIT OF LA LLC

Practice address

3630 Front St
Winnsboro, LA 71295-2224

Phone

(318) 367-0604

Fax

(318) 367-2678

NPI assigned

Aug 21, 2017

Last updated

Jul 28, 2022By 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

Brittney Whitlock

Title

Credentialing Manager

Phone

(318) 325-6200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 3

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.

• Addison Creel, DPT

  • Physical Therapist
  • Jonesville, LA
  • NPI 1063226561
  Medicare reassignment NPD
• Brian T Enlow, PT

  • Physical Therapist
  • Winnsboro, LA
  • NPI 1952349482
  Medicare reassignment
• Alyssa G. Glover, PT

  • Physical Therapist
  • Winnsboro, LA
  • NPI 1093202970
  Medicare reassignment

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1326564311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 FRONT ST",
            "city": "WINNSBORO",
            "state": "LA",
            "postal_code": "712952224",
            "telephone_number": "318-367-0604",
            "fax_number": "318-367-2678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 FRONT ST",
            "city": "WINNSBORO",
            "state": "LA",
            "postal_code": "712952224",
            "telephone_number": "318-367-0604",
            "fax_number": "318-367-2678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEAUX FIT OF LA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-21",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "WHITLOCK",
        "authorized_official_first_name": "BRITTNEY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "318-325-6200"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "07456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Freedom Recovery LLC (Freedom Recovery Winnsboro)
• Fresh Start Outreach Ministries Inc. (Fresh Start Clinic)
• Fresh Start Outreach Ministries Inc.
• Hannah Gable, MS
• Cynthia Gahagan
• William E Gill, PHARM.D
• Amy Glenn
• Alyssa G. Glover, PT
• John Quitman Gowan, LCSW
• Darcy Kavalir Graham

• Physical Therapist in Winnsboro, LA
• Providers in Winnsboro, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; 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.