Individual provider Active NPI

Marc E Bratton, MS, PT, ATC

  • Physical Therapist
  • Slidell, LA
National Provider Identifier
1609911155
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
03642 Issued in LA
Practice address
104 Gause Blvd W
Slidell, LA 70460-2625
Phone
(985) 604-6363
Fax
(985) 607-6364
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0364 LA
Physical Therapist 225100000X 03642 LA Primary

Addresses

Primary practice location

104 Gause Blvd W
Slidell, LA 70460-2625

Mailing address

101 Goldenwood Dr
Slidell, LA 70461-4116
Phone (504) 578-8125

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0364LAMDPhysical Therapist
03642LAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1609911155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 GOLDENWOOD DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704614116",
            "telephone_number": "504-578-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 GAUSE BLVD W",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704602625",
            "telephone_number": "985-604-6363",
            "fax_number": "985-607-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATTON",
        "first_name": "MARC",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "MS, PT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "0364",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "03642",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 30, 2025; 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.