Active NPI
Carol Boudousquie Vallee, PT
- Physical Therapist
- Prairieville, LA
National Provider Identifier
1578620027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 00345
- Practice address
- 18137 Autumn Leaves
Prairieville, LA 70769 - Phone
- (225) 247-2472
- NPI assigned
- Jan 3, 2007
- Sex
- Female
- 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 | 00345 | LA | Primary |
Addresses
Primary practice location
18137 Autumn Leaves
Prairieville, LA 70769
Mailing address
18137 Autumn Leaves
Prairieville, LA 70769
Phone (225) 622-2748
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 |
|---|---|---|---|
| 00345 | LA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578620027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18137 AUTUMN LEAVES",
"city": "PRAIRIEVILLE",
"state": "LA",
"postal_code": "70769",
"telephone_number": "225-622-2748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18137 AUTUMN LEAVES",
"city": "PRAIRIEVILLE",
"state": "LA",
"postal_code": "70769",
"telephone_number": "225-247-2472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALLEE",
"first_name": "CAROL",
"middle_name": "BOUDOUSQUIE",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "00345",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prairieville, 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.