Physical Medicine Center

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

PHYSICAL MEDICINE CENTER

Practice address

401 N College Rd
Ste 3&4
Lafayette, LA 70506-4263

Phone

(337) 233-5230

Fax

(337) 233-5270

NPI assigned

Jun 28, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Derek Todd David, PT

Title

Owner

Phone

(337) 233-5230

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396742953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N COLLEGE RD",
            "address_2": "STE 3&4",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705064263",
            "telephone_number": "337-233-5230",
            "fax_number": "337-233-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N COLLEGE RD",
            "address_2": "STE 3&4",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705064263",
            "telephone_number": "337-233-5230",
            "fax_number": "337-233-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVID",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-233-5230",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan Phillips, PA
• Meggan Phillips, LPC
• Rusty Lane Phillips, LCSW
• Phoebe N Glorias Counseling LLC
• Phoenix Provider Services LLC
• Physical Therapy Advantage
• Physical Therapy Clinic of Lafayette, Inc.
• Physical Therapy Clinic of Lafayette, LLC
• Physical Therapy South, Inc
• Physical Therapy Works, Inc.

• Multi-Specialty Clinic/Center in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Multi-Specialty Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.