Anna Fortunato Payne, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A4574 Issued in LA

Practice address

1160 Hospital Rd Ste 100
New Roads, LA 70760-2633

Phone

(225) 638-4455

Fax

(225) 208-6173

NPI assigned

May 6, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Therapy Center for Physical Rehabilitation and Wellness, LLC

  • Physical Therapist
  • New Roads, LA
  • NPI 1366782120
  NPD (past)
• Thrive Therapy Services, LLC

  • Physical Therapist
  • Saint Francisville, LA
  • NPI 1346702834
  NPD (past)

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1376108316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12669 SHARP LN",
            "city": "PORT ALLEN",
            "state": "LA",
            "postal_code": "707675427",
            "telephone_number": "225-939-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 HOSPITAL RD STE 100",
            "city": "NEW ROADS",
            "state": "LA",
            "postal_code": "707602633",
            "telephone_number": "225-638-4455",
            "fax_number": "225-208-6173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "ANNA",
        "middle_name": "FORTUNATO",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "LA",
            "license": "A4574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A4574",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Our Lady of the Lake Physician Group LLC
• Alaina Ourso, RN
• Richard Gerard Palecki, D.P.M.
• Jeffery Parker
• Andrew Michael Parks, M.D.
• Quentin Payne
• Pediatric Group of Acadiana, LLC (Oxbow Family Practice)
• Performance Home Medical Equipment, LLC
• Jason Joseph Picard, M.D.
• Pointe Coupee Better Access Community Healthcare (Bach)

• Physical Therapy Assistant in New Roads, LA
• Providers in New Roads, LA by specialty
• Physical Therapy Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.