Active NPI
Edward Kevin Mizell, PT
- Physical Therapist
- Covington, LA
National Provider Identifier
1669900858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 000616
- Practice address
- 1414 S Tyler St
Covington, LA 70433-2334 - Phone
- (985) 894-4622
- NPI assigned
- Jun 1, 2017
- Sex
- Male
- Sole proprietor
- No
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 | 000616 | LA | Primary |
Addresses
Primary practice location
1414 S Tyler St
Covington, LA 70433-2334
Mailing address
1414 S Tyler St
Covington, LA 70433-2334
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000616 | LA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496275200000",
"number": "1669900858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1414 S TYLER ST",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704332334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1414 S TYLER ST",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704332334",
"telephone_number": "985-894-4622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIZELL",
"first_name": "EDWARD",
"middle_name": "KEVIN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-01",
"last_updated": "2017-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "000616",
"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 Jun 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.