Gary Joseph Dragon Jr., PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

04523 Issued in LA

Practice address

85 Whisperwood Blvd
Slidell, LA 70458-1136

Phone

(985) 641-2866

Fax

(985) 781-5395

NPI assigned

Jun 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Superior Rehabilitation Services, LLCGroup PAC ID 9436043049, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Superior Rehabilitation Services, LLC

  • Physical Therapy Clinic/Center
  • Slidell, LA
  • NPI 1427084920
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1508807405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S MILITARY RD STE 1",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704614158",
            "telephone_number": "985-641-2866",
            "fax_number": "985-641-7998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 WHISPERWOOD BLVD",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704581136",
            "telephone_number": "985-641-2866",
            "fax_number": "985-781-5395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAGON",
        "first_name": "GARY",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "04523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "G7147",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Michael G. Dragon, D.D.S.
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• Victoria Duarte, LMSW
• Jasmine Ducre
• Tracey Dudenhefer

• Physical Therapist in Slidell, LA
• Providers in Slidell, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.