NPIMap

Organization Active NPI

Northeast Louisiana Rehabilitation

  • Physical Therapist
  • Farmerville, LA
National Provider Identifier
1417349929
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
NORTHEAST LOUISIANA REHABILITATION
Practice address
204 Boots Dr
Farmerville, LA 71241-3102
Phone
(318) 620-0075
Fax
(318) 620-0070
NPI assigned
Feb 21, 2015
Last updated
Nov 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Authorized official

Name
Casey Scarborough Eckhardt, MOT, LOTR, PT, DPTNPI 1790025062
Title
Physical and Occupational Therapist
Phone
(318) 620-0075

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT 08698 LA
Rehabilitation Clinic/Center 261QR0400X OTT.200620 LA
Rehabilitation Clinic/Center 261QR0400X
Physical Therapist 225100000X Primary
Occupational Therapist 225X00000X

Addresses

Primary practice location

204 Boots Dr
Farmerville, LA 71241-3102

Mailing address

246 Alonzo Rd
West Monroe, LA 71291-1731
Phone (318) 620-0075

Other practice location 1

2601 Cypress St
West Monroe, LA 71291-4506
Phone (318) 582-5346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160920003012 LA Part B Supplier - Clinic/Group Practice 8123315025 Receives reassigned benefits from 11 practitioners
Practice locations: Farmerville, LA; West Monroe, LA
O20200521001014 LA DME Supplier - Independently-Practicing Occupational Therapist 8123315025 Practice locations: Farmerville, LA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1424476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732233600000",
    "number": "1417349929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 ALONZO RD",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712911731",
            "telephone_number": "318-620-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 BOOTS DR",
            "city": "FARMERVILLE",
            "state": "LA",
            "postal_code": "712413102",
            "telephone_number": "318-620-0075",
            "fax_number": "318-620-0070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 Cypress St",
            "address_purpose": "LOCATION",
            "city": "West Monroe",
            "state": "LA",
            "postal_code": "712914506",
            "country_code": "US",
            "telephone_number": "318-582-5346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHEAST LOUISIANA REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-21",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A",
        "authorized_official_last_name": "ECKHARDT",
        "authorized_official_first_name": "CASEY",
        "authorized_official_middle_name": "SCARBOROUGH",
        "authorized_official_title_or_position": "PHYSICAL AND OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "318-620-0075",
        "authorized_official_credential": "MOT, LOTR, PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "LA",
            "license": "PT 08698",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "LA",
            "license": "OTT.200620",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmerville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.