Individual provider Active NPI

Clark Leblanc, PT

  • Physical Therapist
  • Breaux Bridge, LA
National Provider Identifier
1376502351
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1006 Issued in LA
Practice address
1220 Berard St
Suite B
Breaux Bridge, LA 70517-4865
Phone
(337) 332-6120
NPI assigned
Mar 20, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 1006 LA Primary

Addresses

Primary practice location

1220 Berard St
Suite B
Breaux Bridge, LA 70517-4865

Mailing address

PO Box 875
Breaux Bridge, LA 70517-0875
Phone (337) 332-6120

Other identifiers 4

IdentifierTypeStateIssuer
1183605OtherLACIGNA
650016821 E0303OtherLARAILROAD MEDICARE
B4436OtherLABLUE CROSS/BLUE SHIELD
70517 A004OtherLACHAMPUS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100924000262 LA Practitioner - Physical Therapist in Private Practice 2668598921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MTS-LGH Therapy Services LLCGroup PAC ID 1052683174, 29 clinicians

Practice addresses (Care Compare)

1400 Rees St
Suite D
Breaux Bridge, LA 70517-4308
Phone (337) 442-6077

2115 Dulles Dr
Lafayette, LA 70506-2652
Phone (337) 981-9182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1006LAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
MTS-LGH Therapy Services LLC Physical Therapist CurrentSince Aug 1, 2017 Accepting new patients
Acadiana Physical Therapy, Inc. Physical Therapist PastSince Jan 1, 2013 Accepting new patients

Locations

1220 N Berard St
Ste B
Breaux Bridge, LA 70517
Phone (337) 332-6120

1400 Rees St
Ste D
Breaux Bridge, LA 70517
Phone (337) 277-8129

201 W Gloria Switch Rd
Ste H
Lafayette, LA 70507
Phone (337) 233-8080

2115 Dulles Dr
Lafayette, LA 70506
Phone (337) 261-0507

327 Iberia St
Ste 2
Youngsville, LA 70592
Phone (337) 856-1717

Organizations & group practices 2

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1376502351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 875",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705170875",
            "telephone_number": "337-332-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 BERARD ST",
            "address_2": "SUITE B",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705174865",
            "telephone_number": "337-332-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "CLARK",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "1006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1183605",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650016821 E0303",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "B4436",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "70517 A004",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Breaux Bridge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.