Individual provider Active NPI

Allison P Boulet, MPT

  • Physical Therapist
  • Jennings, LA
National Provider Identifier
1679754162
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
07320 Issued in LA
Practice address
1322 Elton Rd
Suite I
Jennings, LA 70546-4100
Phone
(337) 824-5488
Fax
(337) 824-5494
NPI assigned
Nov 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 07320 LA Primary

Addresses

Primary practice location

1322 Elton Rd
Suite I
Jennings, LA 70546-4100

Mailing address

1322 Elton Rd
Suite I
Jennings, LA 70546-4100
Phone (337) 824-5488

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

LicenseStateTypeSpecialty
07320LAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1679754162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 ELTON RD",
            "address_2": "SUITE I",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705464100",
            "telephone_number": "337-824-5488",
            "fax_number": "337-824-5494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 ELTON RD",
            "address_2": "SUITE I",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705464100",
            "telephone_number": "337-824-5488",
            "fax_number": "337-824-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULET",
        "first_name": "ALLISON",
        "middle_name": "P",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-26",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "07320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jennings, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.