Individual provider Active NPI

Gabrielle Renee Lafontaine, PT

  • Physical Therapist
  • Baton Rouge, LA
National Provider Identifier
1508559550
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11495 Issued in LA
Practice address
3129 Perkins Rd
Baton Rouge, LA 70808-2254
Phone
(225) 246-2076
Fax
(225) 246-2998
NPI assigned
May 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11495 LA Primary

Addresses

Primary practice location

3129 Perkins Rd
Baton Rouge, LA 70808-2254

Mailing address

4324 S Sherwood Forest Blvd Ste B170
Baton Rouge, LA 70816-4481
Phone (225) 654-8208

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230714002471 LA Practitioner - Physical Therapist in Private Practice 2264892728 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Moreau Physical Therapy Inc. Physical Therapist CurrentSince Jun 5, 2023 Accepting new patients
Alvin C Moreau Jr Licensed Physical Therapist DTD 01 15 82 Physical Therapist CurrentSince Jun 5, 2023 Accepting new patients

Locations

11424 Sullivan Rd
#A-C
Baton Rouge, LA 70818
Phone (225) 261-7021

3129 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 246-2076

4324 S Sherwood Frst
Ste B170
Baton Rouge, LA 70816

1326 Church St
Zachary, LA 70791
Phone 2256548208 ext. 1160

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": "1685059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1508559550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4324 S SHERWOOD FOREST BLVD STE B170",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708164481",
            "telephone_number": "225-654-8208",
            "fax_number": "225-465-8823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3129 PERKINS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708082254",
            "telephone_number": "225-246-2076",
            "fax_number": "225-246-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFONTAINE",
        "first_name": "GABRIELLE",
        "middle_name": "RENEE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-26",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "11495",
            "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 Mar 19, 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.