Individual provider Active NPI

Jane Elizabeth Trahan, PTA

  • Physical Therapy Assistant
  • Slidell, LA
National Provider Identifier
1508976879
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A1975G Issued in LA
Practice address
1601 Shortcut Hwy
Suite B
Slidell, LA 70458-8047
Phone
(985) 641-3818
Fax
(985) 641-3891
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A1975G LA Primary

Addresses

Primary practice location

1601 Shortcut Hwy
Suite B
Slidell, LA 70458-8047

Mailing address

1601 Shortcut Hwy
Suite B
Slidell, LA 70458-8047
Phone (985) 641-3818

Other identifiers 1

IdentifierTypeStateIssuer
A1975GOtherLASTATE LICENSE

Organizations & group practices 1

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 participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A1975GLAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana Therapy and Wellness Center Physical Therapy Assistant Past Accepting new patients

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508976879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 SHORTCUT HWY",
            "address_2": "SUITE B",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704588047",
            "telephone_number": "985-641-3818",
            "fax_number": "985-641-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SHORTCUT HWY",
            "address_2": "SUITE B",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704588047",
            "telephone_number": "985-641-3818",
            "fax_number": "985-641-3891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAHAN",
        "first_name": "JANE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "LA",
            "license": "A1975G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A1975G",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.