Pac PT LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PAC PT LLC

Practice address

1170 Meadowbrook Blvd
Mandeville, LA 70471-7400

Phone

(985) 626-3641

Fax

(985) 626-3792

NPI assigned

Feb 4, 2014

Organization subpart

No

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

Authorized official

Name

David McWilliamsNPI 1033231758

Title

PT

Phone

(985) 626-3641

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Scott McWilliams, MPT

  • Physical Therapist
  • Mandeville, LA
  • NPI 1033231758
  Medicare reassignment NPD Authorized official
• Laurie Occhipinti, PT

  • Physical Therapist
  • Charlotte, NC
  • NPI 1376641555

  LA

  Medicare reassignment NPD
• Jorge Jesam, LMT

  • Massage Therapist
  • Mandeville, LA
  • NPI 1437043601
  NPD
• John Allen Evans, PT

  • Physical Therapist
  • Mandeville, LA
  • NPI 1336263706
  NPD (past)

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

{
    "created_epoch": "1391472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1619391166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 MEADOWBROOK BLVD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704717400",
            "telephone_number": "985-626-3641",
            "fax_number": "985-626-3792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 MEADOWBROOK BLVD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704717400",
            "telephone_number": "985-626-3641",
            "fax_number": "985-626-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAC PT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-04",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "MCWILLIAMS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "985-626-3641"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Montegut Ory, DDS
• Brian D Osborn
• Joy W Ourso, LPN
• Melissa Overstreet
• Lacey Darnell Owens, LPN
• Michelle Elizabeth Pace
• Heather Johnson Palazzo, M.S. CCC-SLP
• Alison R Palmer, CCSH
• Anna Marie Alegre Park, MA, RD, LDN
• Kay Parker, SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.