Individual provider Active NPI

Gerard Lablue, PT

  • Physical Therapist
  • East Peoria, IL
National Provider Identifier
1336820265
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.027475 Issued in IL
Practice address
3000 N Main St Unit a
East Peoria, IL 61611-1713
Phone
(309) 674-7874
NPI assigned
Jul 25, 2023
Last updated
Jul 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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 070.027475 IL Primary

Addresses

Primary practice location

3000 N Main St Unit a
East Peoria, IL 61611-1713

Mailing address

1702 W Baywood Ave
Peoria, IL 61614-5722
Phone (916) 226-9266

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230809002160 IL Practitioner - Physical Therapist in Private Practice 7315309226 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Therapy Services IncGroup PAC ID 0345145843, 17 clinicians

Practice addresses (Care Compare)

1909 N Morton Ave
Morton, IL 61550-1426
Phone (309) 266-5488

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.027475ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Wellness Kansas City, LLC Physical Therapist CurrentSince Jul 27, 2023 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince Jul 27, 2023 Accepting new patients
Professional Therapy Services, Inc Physical Therapist CurrentSince May 15, 2024 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Physical Therapist CurrentSince Jul 27, 2023 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Physical Therapist CurrentSince Jul 27, 2023 Accepting new patients

Locations

1021 W E St
Belleville, IL 62220
Phone (618) 233-2095

2900 Frank Scott Pkwy W
Ste 930
Belleville, IL 62223
Phone (618) 222-9383

525 S Sweetbriar Dr
Chillicothe, IL 61523
Phone (309) 274-2102

7108 Marine Rd
Edwardsville, IL 62025
Phone (618) 706-9759

54 E Fort St
Farmington, IL 61531

1909 N Morton Ave
Morton, IL 61550
Phone (309) 263-9124

2338 W Van Winkle Way
Ste 3100
Peoria, IL 61615
Phone (309) 693-9189

1201 N Cummings Ln
Washington, IL 61571
Phone (309) 444-2090

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 287-3917

Organizations & group practices 5

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": "1690243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1336820265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 W BAYWOOD AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145722",
            "telephone_number": "916-226-9266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N MAIN ST UNIT A",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616111713",
            "telephone_number": "309-674-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABLUE",
        "first_name": "GERARD",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-25",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.027475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.