Individual provider Active NPI

John Derek Laurent, PT, MPT, OCS, CSCS

  • Orthopedic Physical Therapist
  • Baton Rouge, LA
National Provider Identifier
1497846448
Registry record updated Oct 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
06904 Issued in LA
Practice address
13702 Coursey Blvd Ste 10B
Baton Rouge, LA 70817-1370
Phone
(225) 364-3915
Fax
(225) 364-3918
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 06904 LA Primary

Addresses

Primary practice location

13702 Coursey Blvd Ste 10B
Baton Rouge, LA 70817-1370

Mailing address

13702 Coursey Blvd Ste 10B
Baton Rouge, LA 70817-1370
Phone (225) 364-3915

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210720000413 LA Practitioner - Physical Therapist in Private Practice 5193128858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Impact Physical Therapy LLCGroup PAC ID 2466855127, 2 clinicians

Practice addresses (Care Compare)

13702 Coursey Blvd
Suite 10B
Baton Rouge, LA 70817-1370
Phone (225) 364-3915

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06904LAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Physical Therapy LLC Physical Therapist CurrentSince Jun 1, 2021 Accepting new patients
BRPT-Lake Rehabilitation Centers, LLC Past Accepting new patients

Locations

13702 Coursey Blvd
Ste 10B
Baton Rouge, LA 70817
Phone (225) 364-3915

13702 Coursey Blvd
Ste 9B
Baton Rouge, LA 70817
Phone (225) 364-3915

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696118400000",
    "number": "1497846448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13702 COURSEY BLVD STE 10B",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708171370",
            "telephone_number": "225-364-3915",
            "fax_number": "225-364-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13702 COURSEY BLVD STE 10B",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708171370",
            "telephone_number": "225-364-3915",
            "fax_number": "225-364-3918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURENT",
        "first_name": "JOHN",
        "middle_name": "DEREK",
        "name_prefix": "Mr.",
        "credential": "PT, MPT, OCS, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2023-10-01",
        "certification_date": "2023-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "LA",
            "license": "06904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2023; 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.