Lance Angelle, PT

Individual provider Active NPI Physical Therapist · Baton Rouge, LA

NPI 1467097550 · NPPES record last updated Feb 9, 2024

Key facts

NPI
1467097550
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
34014 (FL)
Practice address
5258 Dijon Dr
Baton Rouge, LA 70808-4311
Phone
(225) 256-3828
Fax
(225) 256-3829
NPI assigned
Nov 12, 2019
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
At Still University, Arizona School of Dentistry & Oral HLTH, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Parish Therapy Center, LLC (26 clinicians)

Practice addresses (Care Compare)

5258 Dijon Dr
Baton Rouge, LA 70808-4311
Phone (225) 256-3828

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20200210001917 LA Practitioner - Physical Therapist in Private Practice 9335575455 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
34014FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Parish Therapy Center LLC Physical Therapist Current
since Jan 1, 2024
Accepting new patients
Louisiana Ear, Nose, Throat & Sinus, LLC Past Accepting new patients

Locations

5258 Dijon Dr
Baton Rouge, LA 70808
Phone (225) 408-6900

900 Pershing Hwy
Jonesboro, LA 71251
Phone (318) 224-8994

16172 Airline Hwy
#B
Prairieville, LA 70769
Phone (225) 255-4020

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 34014 FL Yes

Addresses

Primary practice location

5258 Dijon Dr
Baton Rouge, LA 70808-4311

Mailing address

604 N Acadia Rd Ste 101
Thibodaux, LA 70301-4897
Phone (985) 446-5079

Other providers in Baton Rouge, LA

All providers in Baton Rouge, LA · Physical Therapist in Louisiana

Sources for this page

Verify at the official NPI Registry.