Delta Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

DELTA PHYSICAL THERAPY LLC

Practice address

12110 S Harrells Ferry Rd Ste 200
Baton Rouge, LA 70816-2426

Phone

(225) 372-5008

Fax

(225) 308-4704

NPI assigned

Nov 1, 2016

Last updated

Apr 11, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kristen Locicero Glascock, PT, DPTNPI 1922460765

Title

Owner

Phone

(225) 372-5008

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 5

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.

• Kristen Locicero Glascock, PT, DPT

  • Physical Therapist
  • Baton Rouge, LA
  • NPI 1922460765
  Medicare reassignment Care Compare group NPD Authorized official
• Clint A Caballero, DPT

  • Physical Therapist
  • Baton Rouge, LA
  • NPI 1952849705
  Medicare reassignment Care Compare group NPD
• Stephen Matthew Levins, PT, MSC, OCS

  • Physical Therapist
  • Baton Rouge, LA
  • NPI 1376654723
  Medicare reassignment Care Compare group NPD
• Mason G Porter, DPT

  • Physical Therapist
  • Hammond, LA
  • NPI 1669923397
  Medicare reassignment Care Compare group NPD
• Stephanie Wills, PTA

  • Physical Therapist
  • Baton Rouge, LA
  • NPI 1841108255
  NPD (past)

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712793600000",
    "number": "1790237188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12110 S HARRELLS FERRY RD STE 200",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708162426",
            "telephone_number": "225-372-5008",
            "fax_number": "225-308-4704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12110 S HARRELLS FERRY RD STE 200",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708162426",
            "telephone_number": "225-372-5008",
            "fax_number": "225-308-4704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 S Magnolia St Ste C",
            "address_purpose": "LOCATION",
            "city": "Hammond",
            "state": "LA",
            "postal_code": "704035078",
            "country_code": "US",
            "telephone_number": "985-662-0177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DELTA PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-01",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A",
        "authorized_official_last_name": "GLASCOCK",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "LOCICERO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-372-5008",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Bolt Delhommer, CRNA
• Alysia Delone
• Courtney Nelson Delone, PHARMD
• Erin Acosta Delrie, MSN, FNP-C
• Laura Nicole Delrose
• Rebecca E. Demanuelle
• Gabrielle Alona Demaria
• Thomas A Demars, M.D.
• Democracy Prep Louisiana Charter
• Jeffrey A Demouy, M.D.

• Physical Therapy Clinic/Center in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Physical Therapy Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.