Organization Active NPI

Integrated Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Lafayette, LA
National Provider Identifier
1447529490
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
INTEGRATED PHYSICAL THERAPY, LLC
Practice address
218 Rue Louis Xiv
Suite a
Lafayette, LA 70508-5766
Phone
(337) 456-6148
Fax
(337) 456-6239
NPI assigned
Dec 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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

Authorized official

Name
Alix Sorrel, PT, DPTNPI 1770729162
Title
Member/Manager
Phone
(337) 380-2823

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

218 Rue Louis Xiv
Suite a
Lafayette, LA 70508-5766

Mailing address

218 Rue Louis Xiv
Suite a
Lafayette, LA 70508-5766
Phone (337) 456-6148

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120314000146 LA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0749449585 Receives reassigned benefits from 2 practitioners
Practice locations: Lafayette, LA

National Provider Directory

National Provider Directory

Locations

121 Rue Louis Xiv
Bldg 6A
Lafayette, LA 70508
Phone (337) 456-6148

218 Rue Louis Xiv
Ste A
Lafayette, LA 70508
Phone (337) 295-3330

1600 Camellia Blvd
Bldg C
Lafayette, LA 70508
Phone (337) 456-6148

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324339200000",
    "number": "1447529490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 RUE LOUIS XIV",
            "address_2": "SUITE A",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085766",
            "telephone_number": "337-456-6148",
            "fax_number": "337-456-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 RUE LOUIS XIV",
            "address_2": "SUITE A",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085766",
            "telephone_number": "337-456-6148",
            "fax_number": "337-456-6239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-20",
        "last_updated": "2011-12-20",
        "status": "A",
        "authorized_official_last_name": "SORREL",
        "authorized_official_first_name": "ALIX",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "337-380-2823",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.