NPIMap

Organization Active NPI

Therapy Center of Jefferson Davis Parish, Inc

  • Physical Therapist
  • Jennings, LA
National Provider Identifier
1508971045
Registry record updated Sep 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
THERAPY CENTER OF JEFFERSON DAVIS PARISH, INC
Practice address
2002 Johnson St
Suite 100
Jennings, LA 70546-3646
Phone
(337) 824-4547
Fax
(337) 824-4548
NPI assigned
Aug 21, 2006
Last updated
Sep 3, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2009

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

Authorized official

Name
Mrs. Elisha N Duhon
Title
Co-Office Manager
Phone
(337) 824-4547

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X LA
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X LA Primary
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X LA
Athletic TrainerGroup: 193200000X MULTI-SPECIALTY GROUP 2255A2300X LA
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X LA
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X LA

Addresses

Primary practice location

2002 Johnson St
Suite 100
Jennings, LA 70546-3646

Mailing address

2002 Johnson St
Suite 100
Jennings, LA 70546-3646
Phone (337) 824-4547

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050120000627 LA Part B Supplier - Clinic/Group Practice 0345207544 Receives reassigned benefits from 43 practitioners
Practice locations: Carencro, LA; Lake Charles, LA; Lafayette, LA; Jennings, LA; Jeanerette, LA; Grand Coteau, LA

National Provider Directory

National Provider Directory

Locations

1509 I49 N Service Rd
Grand Coteau, LA 70584

2002 Johnson St
Ste 100
Jennings, LA 70546
Phone (337) 824-8287

105 Patriot St
Ste 200
Lafayette, LA 70508

105 Patriot St
Ste 201
Lafayette, LA 70508
Phone (337) 345-1957

4451 Nelson Rd
Lake Charles, LA 70605
Phone (337) 480-0027

1509 I49 N Service Rd
Sunset, LA 70584

Practitioners & affiliated clinicians

Practitioners 135

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 135

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251936000000",
    "number": "1508971045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 JOHNSON ST",
            "address_2": "SUITE 100",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463646",
            "telephone_number": "337-824-4547",
            "fax_number": "337-824-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 JOHNSON ST",
            "address_2": "SUITE 100",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463646",
            "telephone_number": "337-824-4547",
            "fax_number": "337-824-4548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPY CENTER OF JEFFERSON DAVIS PARISH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2009-09-03",
        "status": "A",
        "authorized_official_last_name": "DUHON",
        "authorized_official_first_name": "ELISHA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CO-OFFICE MANAGER",
        "authorized_official_telephone_number": "337-824-4547",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": null,
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jennings, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; 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.