Peyton Bonvillain, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11930 Issued in LA

Practice address

508 N Acadia Rd
Thibodaux, LA 70301-4862

Phone

(985) 448-5888

Fax

(985) 448-0589

NPI assigned

Sep 3, 2024

Last updated

Sep 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advance Physcial Therapy and RehabilitationGroup PAC ID 6204734379, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advance Physcial Therapy and Rehabilitation

  • Physical Therapy Clinic/Center
  • Thibodaux, LA
  • NPI 1750502688
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1725321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1366277170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 N ACADIA RD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014862",
            "telephone_number": "985-448-5888",
            "fax_number": "985-448-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 N ACADIA RD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014862",
            "telephone_number": "985-448-5888",
            "fax_number": "985-448-0589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONVILLAIN",
        "first_name": "PEYTON",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "11930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Bollinger
• Jordyn Serigne Bollinger, LPC
• Breanne Bonin
• Cierra Bonvillain
• Kaitlyn Bonvillain, OTR/L
• Allen T Borne, M.D.
• Caitlin Lopes Borne, M.D.
• David H Borne, M.D.
• Nikki O. Borne, LCSW
• William L Borskey, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.