Individual provider Active NPI

Gregory James Redmond, DPT

  • Physical Therapist
  • Shreveport, LA
National Provider Identifier
1407894355
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05083 Issued in LA
Practice address
820 Jordan St Ste 150
Shreveport, LA 71101-4529
Phone
(318) 344-1840
Fax
(800) 959-0163
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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 05083 LA Primary

Addresses

Primary practice location

820 Jordan St Ste 150
Shreveport, LA 71101-4529

Mailing address

820 Jordan St Ste 150
Shreveport, LA 71101-4529
Phone (318) 222-7442

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140522002356 LA Practitioner - Physical Therapist in Private Practice 5294958047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Miami, LM Miller School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

820 Jordan St
Suite 150
Shreveport, LA 71101-4529
Phone (318) 222-7442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05083LAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eberhardt Physical Therapy & Wellness Clinic, Inc. Physical Therapist CurrentSince Feb 17, 2014 Accepting new patients

Locations

820 Jordan St
Ste 150
Shreveport, LA 71101
Phone (318) 222-7442

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1407894355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 JORDAN ST STE 150",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014529",
            "telephone_number": "318-222-7442",
            "fax_number": "318-424-4751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 JORDAN ST STE 150",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014529",
            "telephone_number": "318-344-1840",
            "fax_number": "800-959-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDMOND",
        "first_name": "GREGORY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "05083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; 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.