Individual provider Active NPI

Teri Lynn Lasalle, PT

  • Specialist
  • Providence, RI
National Provider Identifier
1740201441
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT01943 Issued in RI
Practice address
2 Dudley St
Suite 200
Providence, RI 02905-3236
Phone
(401) 277-0790
Fax
(401) 277-0795
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5509 SC
Specialist 174400000X PT01943 RI Primary

Addresses

Primary practice location

2 Dudley St
Suite 200
Providence, RI 02905-3236

Mailing address

180 Acres of Pine Rd
Coventry, RI 02816-8955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250429002593 SC Practitioner - Physical Therapist in Private Practice 4385688522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Duke University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1910 Blanding St
Columbia, SC 29201-3520
Phone (803) 256-4107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5509SCMDProfessional Counselor
PT01943RIMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Midlands Orthopaedics and Neurosurgery PA CurrentSince Apr 1, 2025 Accepting new patients
Midlands Orthopaedics and Neurosurgery, PA CurrentSince Apr 1, 2025 Accepting new patients

Locations

1930 Blanding St
Columbia, SC 29201
Phone (803) 461-4740

1910 Blanding St
Columbia, SC 29201
Phone (803) 253-6721

109 Park Place Ct
Lexington, SC 29072
Phone (803) 933-6784

Interoperability endpoints

  • Direct secure messaging: teri.lasalle.1@5499.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1740201441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 ACRES OF PINE RD",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028168955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DUDLEY ST",
            "address_2": "SUITE 200",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053236",
            "telephone_number": "401-277-0790",
            "fax_number": "401-277-0795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASALLE",
        "first_name": "TERI",
        "middle_name": "LYNN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "5509",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "RI",
            "license": "PT01943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.