Active NPI
Mary Grace Jordan Douglas, PT
- Physical Therapist
- Belle Chasse, LA
National Provider Identifier
1639783822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10836F
- Practice address
- 8397 Highway 23 Ste 101
Belle Chasse, LA 70037-2609 - Phone
- (504) 398-2004
- NPI assigned
- Sep 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 10836F | LA | Primary |
Addresses
Primary practice location
8397 Highway 23 Ste 101
Belle Chasse, LA 70037-2609
Mailing address
358 Princeton Cir
Belle Chasse, LA 70037-1311
Phone (256) 527-1177
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14961836 | Other | LA | CAQH |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://rehabaccess.com | Direct |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10836F | LA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647993600000",
"number": "1639783822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "358 PRINCETON CIR",
"city": "BELLE CHASSE",
"state": "LA",
"postal_code": "700371311",
"telephone_number": "256-527-1177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8397 HIGHWAY 23 STE 101",
"city": "BELLE CHASSE",
"state": "LA",
"postal_code": "700372609",
"telephone_number": "504-398-2004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "MARY GRACE",
"middle_name": "JORDAN",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-03",
"last_updated": "2022-03-23",
"certification_date": "2022-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "10836F",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "14961836",
"state": "LA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://rehabaccess.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "8397 Highway 23 Ste 101",
"city": "Belle Chasse",
"state": "LA",
"country_code": "US",
"postal_code": "700372609",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Belle Chasse, LA
- Dejeanne Denet, D.C.
- Denis Lockler, Anp, PLLC
- Dept of Health & Hospitals (Plaquemines Behavioral Health Clinic)
- Destiny Chiropractic Clinic LLC
- Jeffrey Ciro Dimarco, RPH
- Peyton Dufour
- Epic Physical Therapy, LLC
- Essential Intentions Counseling, LLC
- Fast Aid Medical LLC
- Fast Aid Urgent Care- Belle Chasse
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.