Lincoln Outpatient Therapy Services

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

LINCOLN OUTPATIENT THERAPY SERVICES

Practice address

1817 Northpointe Lane
Ruston, LA 71270-3879

Phone

(318) 255-9601

Fax

(318) 255-7971

NPI assigned

Mar 16, 2006

Last updated

Dec 15, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew Randolph Shirley, PTNPI 1477750578

Title

President

Phone

(318) 255-9601

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jereme Brian Johnson, DPT

  • Physical Medicine & Rehabilitation Physician
  • Jena, LA
  • NPI 1336435387
  Medicare reassignment
• Brent Boardman, PT

  • Physical Therapist
  • Carson City, NV
  • NPI 1871535807

  LA

  Medicare reassignment
• Robert Chase Patterson, D.P.T.

  • Physical Therapist
  • Weatherford, TX
  • NPI 1811347768

  LA

  Medicare reassignment
• Matthew Shirley, PT

  • Physical Therapist
  • Ruston, LA
  • NPI 1477750578
  Authorized official Same address or phone
• Tanner Dunn, PT, DPT

  • Physical Medicine & Rehabilitation Physician
  • Ruston, LA
  • NPI 1336036946
  NPD
• Jonathan Seth Fleming

  • Orthopedic Physical Therapist
  • Ruston, LA
  • NPI 1902790173
  NPD
• Joseph Brown, ST

  • Speech-Language Pathologist
  • Ruston, LA
  • NPI 1497952501
  NPD (past)
• Anne P Colvin, OT

  • Occupational Therapist
  • Ruston, LA
  • NPI 1245437334
  NPD (past)
• Dan Dupree, PT

  • Physical Therapist
  • Ruston, LA
  • NPI 1083813042
  NPD (past)
• Brittany B Griep

  • Speech-Language Pathologist
  • Ruston, LA
  • NPI 1326299074
  NPD (past)
• Cynthia Hendrix, O.T.

  • Occupational Therapist
  • Ruston, LA
  • NPI 1447701271
  NPD (past)
• Jan E. Lewis, P.T.

  • Physical Therapist
  • Ruston, LA
  • NPI 1417199472
  NPD (past)

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323907200000",
    "number": "1407825060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1306",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712731306",
            "telephone_number": "318-255-9601",
            "fax_number": "318-255-7971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 NORTHPOINTE LANE",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712703879",
            "telephone_number": "318-255-9601",
            "fax_number": "318-255-7971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN OUTPATIENT THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-16",
        "last_updated": "2011-12-15",
        "status": "A",
        "authorized_official_last_name": "SHIRLEY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "RANDOLPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-255-9601",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7822443",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1169234",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lincoln Health System (Lincoln General Hospital)
• Lincoln Health System (Lincoln General Hospital)
• Lincoln Medical Clinic LLC
• Lincoln Nova Vital Recovery
• Lincoln Nova Vital Recovery Center,LLC
• Lincoln Parish Police Jury (Humanitarian Enterprises of Lincoln Parish)
• Lincoln Parish Police Jury
• Lincoln Parish School Board
• Lincoln Parish School Board
• Lincoln Parish School Board

• Rehabilitation Clinic/Center in Ruston, LA
• Providers in Ruston, LA by specialty
• Rehabilitation Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.