Organization Active NPI

Physical Therapy Clinic of Rayne, Inc.

  • Physical Therapist
  • Rayne, LA
National Provider Identifier
1790859809
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT0163 Issued in LA
Legal business name
PHYSICAL THERAPY CLINIC OF RAYNE, INC.
Practice address
500 W Branche St
Rayne, LA 70578-5026
Phone
(337) 334-9207
Fax
(337) 334-9208
NPI assigned
Nov 20, 2006
Last updated
Aug 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Authorized official

Name
Mr. Judd J Gautreaux, PT
Title
Owner
Phone
(337) 334-9207

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT0163 LA Primary

Addresses

Primary practice location

500 W Branche St
Rayne, LA 70578-5026

Mailing address

500 W Branche St
Rayne, LA 70578-5026
Phone (337) 334-9207

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070110000270 LA Part B Supplier - Clinic/Group Practice 2668472903 Receives reassigned benefits from 1 practitioner
Practice locations: Rayne, LA

National Provider Directory

National Provider Directory

Locations

500 W Branche St
Rayne, LA 70578
Phone (337) 334-9207

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755648000000",
    "number": "1790859809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W BRANCHE ST",
            "city": "RAYNE",
            "state": "LA",
            "postal_code": "705785026",
            "telephone_number": "337-334-9207",
            "fax_number": "337-334-9208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BRANCHE ST",
            "city": "RAYNE",
            "state": "LA",
            "postal_code": "705785026",
            "telephone_number": "337-334-9207",
            "fax_number": "337-334-9208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY CLINIC OF RAYNE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A",
        "authorized_official_last_name": "GAUTREAUX",
        "authorized_official_first_name": "JUDD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-334-9207",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "PT0163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rayne, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.