Active NPI
Jeff Shay, MPT
- Physical Therapist
- Gonzales, LA
National Provider Identifier
1568490209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 04983
- Practice address
- 328 S Burnside Ave
Gonzales, LA 70737-3444 - Phone
- (225) 644-7510
- Fax
- (225) 644-2660
- NPI assigned
- Jun 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 04983 | LA | Primary |
Addresses
Primary practice location
328 S Burnside Ave
Gonzales, LA 70737-3444
Mailing address
11320 Industriplex Boulevard
Baton Rouge, LA 70809
Phone (225) 295-8183
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
| License | State | Type | Specialty |
|---|---|---|---|
| 04983 | LA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peak Performance Physical Therapy and Fitness, LLC | Physical Therapist | Past | Accepting new patients |
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.
-
- Physical Therapist
- Baton Rouge, LA
- NPI 1912931437
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568490209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11320 INDUSTRIPLEX BOULEVARD",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "70809",
"telephone_number": "225-295-8183",
"fax_number": "225-752-2937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "328 S BURNSIDE AVE",
"city": "GONZALES",
"state": "LA",
"postal_code": "707373444",
"telephone_number": "225-644-7510",
"fax_number": "225-644-2660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAY",
"first_name": "JEFF",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "04983",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gonzales, 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.