NPIMap

Organization Active NPI

Bienville Therapy, LLC

  • Physical Therapist
  • Vancleave, MS
National Provider Identifier
1720844392
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BIENVILLE THERAPY, LLC
Practice address
6300 E Lake Blvd Ste 101
Vancleave, MS 39565-6771
Phone
(228) 230-2663
NPI assigned
Feb 22, 2024
Last updated
Apr 17, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
BIENVILLE ORTHOPAEDIC SPECIALISTS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Authorized official

Name
Lee Bond
Title
Ceo
Phone
(228) 230-2663

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

6300 E Lake Blvd Ste 101
Vancleave, MS 39565-6771

Mailing address

6300 E Lake Blvd Ste 301
Vancleave, MS 39565-6771
Phone (228) 230-2663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240807000999 MS Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1254878325 Receives reassigned benefits from 28 practitioners
3 other NPIs on this enrollment
Practice locations: Biloxi, MS; Gulfport, MS; Pascagoula, MS; Vancleave, MS
O20250625000546 MS DME Supplier - Independently-Practicing Occupational TherapistDME Supplier - Independently-Practicing Physical Therapist 1254878325 Practice locations: Vancleave, MS

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Bienville Therapy LLC4 organizations share this tax ID, including this one
Part of
Bienville Ortho Spec

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1708560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1720844392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 E LAKE BLVD STE 301",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395656771",
            "telephone_number": "228-230-2663",
            "fax_number": "228-206-6398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 E LAKE BLVD STE 101",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395656771",
            "telephone_number": "228-230-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIENVILLE THERAPY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BIENVILLE ORTHOPAEDIC SPECIALISTS LLC",
        "enumeration_date": "2024-02-22",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "BOND",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "228-230-2663"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancleave, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.