John Daniel Boudreaux, PT, ATC, LAT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

06867 Issued in LA

Practice address

816 Harding St
Lafayette, LA 70503-2320

Phone

(337) 232-3111

Fax

(337) 232-5400

NPI assigned

Jun 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• MTS-LGH Therapy Services LLC

  • Physical Therapist
  • Lafayette, LA
  • NPI 1972024081
  Medicare reassignment NPD
• Lemoine Therapy Services of Cenla Inc

  • Physical Therapist
  • Mansura, LA
  • NPI 1336242767
  NPD (past)
• Therapy Center of Jefferson Davis Parish, Inc

  • Physical Therapist
  • Jennings, LA
  • NPI 1508971045
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375747200000",
    "number": "1730116617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 MEADOWBROOK DR",
            "city": "BROUSSARD",
            "state": "LA",
            "postal_code": "705184791",
            "telephone_number": "337-802-5652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 HARDING ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032320",
            "telephone_number": "337-232-3111",
            "fax_number": "337-232-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "JOHN",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "PT, ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2013-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "06867",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "LA",
            "license": "J00368",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emilie T Boudreaux, ANP
• Emily Nicole Boudreaux, FNP
• Hannah Boudreaux
• Jarod Boudreaux, CRNA
• Jeffrey David Boudreaux, O.D.
• Kathleen Marie Boudreaux, P.M.H.N.P.
• Kristin Lucas Boudreaux, DC, MSN, APRN
• Lindsay Harwin Boudreaux
• Lisa A Boudreaux, CPC
• Lucette Boudreaux, RN

• Physical Therapist in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; 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.