Active NPI
Gerardo Adonis Santiago, PT
- Physical Therapist
- Columbia, LA
National Provider Identifier
1760657852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 01144F
- Practice address
- 7726 US Hwy 165
Haven Rehabilitation Center
Columbia, LA 71418 - Phone
- (318) 649-9826
- Fax
- (318) 649-9827
- NPI assigned
- Apr 29, 2008
- Sex
- Male
- 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 | 01144F | LA | Primary |
Addresses
Primary practice location
7726 US Hwy 165
Haven Rehabilitation Center
Columbia, LA 71418
Mailing address
7726 US Hwy 165
Haven Rehabilitation Center
Columbia, LA 71418
Phone (318) 649-9826
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G7648 | Other | LA | BLUE CROSS OF LOUISIANA |
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 |
|---|---|---|---|
| 01144F | LA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209427200000",
"number": "1760657852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7726 US HWY 165",
"address_2": "HAVEN REHABILITATION CENTER",
"city": "COLUMBIA",
"state": "LA",
"postal_code": "71418",
"telephone_number": "318-649-9826",
"fax_number": "318-649-9827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7726 US HWY 165",
"address_2": "HAVEN REHABILITATION CENTER",
"city": "COLUMBIA",
"state": "LA",
"postal_code": "71418",
"telephone_number": "318-649-9826",
"fax_number": "318-649-9827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO",
"first_name": "GERARDO",
"middle_name": "ADONIS",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-29",
"last_updated": "2008-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "01144F",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF LOUISIANA",
"identifier": "G7648",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.