Core Physical Therapy and Performance, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

CORE PHYSICAL THERAPY AND PERFORMANCE, LLC

Practice address

460 Ashley Ridge Blvd Ste 800
Shreveport, LA 71106-7238

Phone

(318) 868-6172

Fax

(318) 868-6173

NPI assigned

Aug 24, 2015

Last updated

Aug 24, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brennan BernardNPI 1942509997

Title

PT/Co-Pwner

Phone

(318) 868-6172

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 10

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.

• Brennan Anthony Bernard

  • Physical Therapist
  • Shreveport, LA
  • NPI 1942509997
  Medicare reassignment Care Compare group NPD Authorized official
• Megan Sierra Jones, P.T.

  • Physical Therapist
  • Shreveport, LA
  • NPI 1700511003
  Medicare reassignment Care Compare group NPD
• Lance Tucker

  • Physical Therapist
  • Shreveport, LA
  • NPI 1982289997
  Medicare reassignment Care Compare group NPD
• Christopher Fultz, DPT

  • Physical Therapist
  • Shreveport, LA
  • NPI 1952790917
  Medicare reassignment NPD
• Mary C Kneip, PT

  • Physical Therapist
  • Shreveport, LA
  • NPI 1790521334
  Medicare reassignment NPD
• Mason L McGee, DPT

  • Physical Therapist
  • Shreveport, LA
  • NPI 1871926360
  Medicare reassignment NPD
• Trent Matthew Andre

  • Physical Therapist
  • Shreveport, LA
  • NPI 1053966192
  NPD
• Jennifer Magee Domengeaux, SLP

  • Speech-Language Pathologist
  • Lafayette, LA
  • NPI 1982975785
  NPD (past)
• Braden Guidry, PT

  • Physical Therapist
  • Lafayette, LA
  • NPI 1164846705
  NPD (past)
• Meredith Preis Lalonde, O.T.

  • Occupational Therapist
  • Lafayette, LA
  • NPI 1285972224
  NPD (past)

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440374400000",
    "number": "1609243716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53614",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705053614",
            "telephone_number": "337-233-7977",
            "fax_number": "337-233-7978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 ASHLEY RIDGE BLVD STE 800",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067238",
            "telephone_number": "318-868-6172",
            "fax_number": "318-868-6173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE PHYSICAL THERAPY AND PERFORMANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-08-24",
        "status": "A",
        "authorized_official_last_name": "BERNARD",
        "authorized_official_first_name": "BRENNAN",
        "authorized_official_title_or_position": "PT/CO-PWNER",
        "authorized_official_telephone_number": "318-868-6172",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyra Cooper
• Paige Copeland
• Tiaqua M Copeland
• Angela Corbin
• Charles Corder
• Randall C Cork, M.D.
• Victoria Brignac Corley, MD
• Brandon Corliss, PHARM.D
• Adam P. Cormier, D.D.S.
• Clint M Cormier, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.