Kelli Theriot, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

09943R Issued in LA

Practice address

4141 Common St
Lake Charles, LA 70607-4501

Phone

(337) 990-5621

Fax

(337) 990-5623

NPI assigned

Mar 7, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelli Lauren Mancil Former name

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1741305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1730987314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 COMMON ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706074501",
            "telephone_number": "337-990-5621",
            "fax_number": "337-990-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 COMMON ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706074501",
            "telephone_number": "337-990-5621",
            "fax_number": "337-990-5623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THERIOT",
        "first_name": "KELLI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-07",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "09943R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "MANCIL",
            "middle_name": "LAUREN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• The Plastic Surgery Center of Southwest Louisiana, LLC
• The Recovery Project
• Therapy Works of Swla LLC
• Theresa M Ivey LLC
• Jacob M Theriot, FNP-C
• Michael Todd Theriot, D.C.
• Travis Edward Theriot, MS, LAT, ATC
• Kirk James Thibeaux, MBA
• Colby Ryan Thibodeaux, FNP
• Elise Thibodeaux

• Physical Therapist in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.