Active NPI
Jessica Weicht
- Physical Therapist
- Shreveport, LA
National Provider Identifier
1710637525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 38170
- Practice address
- 510 E Stoner Ave
Shreveport, LA 71101-4243 - Phone
- (318) 221-8411
- NPI assigned
- Mar 25, 2022
- Sex
- Female
- 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 | 38170 | FL | Primary |
Addresses
Primary practice location
510 E Stoner Ave
Shreveport, LA 71101-4243
Mailing address
3710 Honeysuckle LN
Texarkana, TX 75503-2231
Phone (804) 436-5961
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 |
|---|---|---|---|
| 38170 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722470400000",
"number": "1710637525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3710 HONEYSUCKLE LN",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755032231",
"telephone_number": "804-436-5961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 E STONER AVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711014243",
"telephone_number": "318-221-8411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEICHT",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-25",
"last_updated": "2024-08-01",
"certification_date": "2024-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "38170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.