Myra D. Buller, P.T., C.S.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

LA00619 Issued in LA

Practice address

8015 Rod Laver Ave
Baton Rouge, LA 70810

Phone

(504) 495-6855

Fax

(225) 767-0423

NPI assigned

Nov 16, 2006

Last updated

May 1, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Omni Therapy

  • Physical Therapist
  • Baton Rouge, LA
  • NPI 1093872491
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1447323431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8015 ROD LAVER AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70810",
            "telephone_number": "504-495-6855",
            "fax_number": "225-767-0423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8015 ROD LAVER AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70810",
            "telephone_number": "504-495-6855",
            "fax_number": "225-767-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLER",
        "first_name": "MYRA",
        "middle_name": "D.",
        "credential": "P.T., C.S.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "LA00619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keenan James Buie
• Build-a-Wig
• Theresa Pate Builder
• Luke Steven Bujenovic, M.D.
• Chermeka Bullard, BS
• Matthew Bumgardner, M.D.
• Patricia Bumpers
• Joshua Vaughn Bunch, ATC, LAT
• Luke Adam Bunch, DPT
• Matthew Bunch, DPT

• Physical Therapist in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; 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.