Individual provider Active NPI

Shannon J Lemoine, PT

  • Physical Therapist
  • Marksville, LA
National Provider Identifier
1346394244
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
03213 Issued in LA
Practice address
554 Tunica Dr W
Marksville, LA 71351-2627
Phone
(318) 240-7680
Fax
(318) 240-7681
NPI assigned
Jan 22, 2007
Last updated
Nov 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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 03213 LA Primary

Addresses

Primary practice location

554 Tunica Dr W
Marksville, LA 71351-2627

Mailing address

2002 Johnson St
Ste 100
Jennings, LA 70546-3640
Phone (318) 240-7680

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050203000027 LA Practitioner - Physical Therapist in Private Practice 3971560178 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapy Center of Jefferson Davis Parish, IncGroup PAC ID 0345207544, 19 clinicians
Lemoine Therapy Services of Cenla IncGroup PAC ID 4789635244, 11 clinicians

Practice addresses (Care Compare)

2002 Johnson St
Suite 100
Jennings, LA 70546-3640
Phone (337) 824-4547

7406 Hwy 1
Suite 102
Mansura, LA 71350-4204
Phone (318) 240-7680

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lemoine Therapy Services of Cenla Inc Physical Therapist CurrentSince Jan 1, 2005 Accepting new patients
Therapy Center of Jefferson Davis Parish, Inc Physical Therapist CurrentSince Mar 4, 2002 Accepting new patients
Physical Therapy Clinic of Carencro LLC Physical Therapist Past Accepting new patients

Locations

4501 Jackson St
Ste D
Alexandria, LA 71303
Phone (318) 704-0710

204 E Saint Peter St
Carencro, LA 70520
Phone (337) 896-6685

1401 Church St
Jeanerette, LA 70544
Phone (337) 276-2803

2002 Johnson St
Ste 100
Jennings, LA 70546
Phone (337) 824-8287

105 Patriot St
Ste 201
Lafayette, LA 70508
Phone (337) 345-1957

4451 Nelson Rd
Lake Charles, LA 70605
Phone (337) 480-0027

7406 Highway 1
Ste 102
Mansura, LA 71350
Phone (318) 240-7680

554 Tunica Dr W
Marksville, LA 71351
Phone (318) 240-7680

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Acadia St. Landry Nursing & Rehabilitation CenterChurch Point, LA, CCN 195564 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (7.5%)
Adp of the SNF
Jul 15, 2022
Jul 15, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1346394244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 JOHNSON ST",
            "address_2": "STE 100",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463640",
            "telephone_number": "318-240-7680",
            "fax_number": "318-240-7681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 TUNICA DR W",
            "city": "MARKSVILLE",
            "state": "LA",
            "postal_code": "713512627",
            "telephone_number": "318-240-7680",
            "fax_number": "318-240-7681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMOINE",
        "first_name": "SHANNON",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "03213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marksville, LA

Sources for this page

Verify at the official NPI Registry.