NPIMap

Organization Active NPI

Landers Physical Therapy Services, LLC

  • Physical Therapist
  • Covington, LA
National Provider Identifier
1669524195
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT04633 Issued in LA
Legal business name
LANDERS PHYSICAL THERAPY SERVICES, LLC
Practice address
1010 S Polk St
Suite 2
Covington, LA 70433-2474
Phone
(985) 809-9088
Fax
(985) 809-9270
NPI assigned
Jan 17, 2007
Last updated
Oct 12, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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

Authorized official

Name
Dr. P.J. Landers, DPT, MTC, OCSNPI 1689670788
Title
Doctor of Physical Therapy
Phone
(985) 809-9088

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT04633 LA Primary

Addresses

Primary practice location

1010 S Polk St
Suite 2
Covington, LA 70433-2474

Mailing address

1010 S Polk St
Suite 2
Covington, LA 70433-2474
Phone (985) 809-9088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040804001523 LA Part B Supplier - Clinic/Group Practice 4486625209 Receives reassigned benefits from 2 practitioners
Practice locations: Covington, LA; Mandeville, LA

National Provider Directory

National Provider Directory

Locations

1010 S Polk St
#2
Covington, LA 70433
Phone (337) 298-6240

405 S Tyler St
Covington, LA 70433
Phone (337) 298-6240

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1669524195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 S POLK ST",
            "address_2": "SUITE 2",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704332474",
            "telephone_number": "985-809-9088",
            "fax_number": "985-809-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S POLK ST",
            "address_2": "SUITE 2",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704332474",
            "telephone_number": "985-809-9088",
            "fax_number": "985-809-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANDERS PHYSICAL THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "LANDERS",
        "authorized_official_first_name": "P.J.",
        "authorized_official_title_or_position": "DOCTOR OF PHYSICAL THERAPY",
        "authorized_official_telephone_number": "985-809-9088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT, MTC, OCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "PT04633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; 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.