Pediatric Therapy Center

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

PEDIATRIC THERAPY CENTER

Practice address

1300 Jackson St
Alexandria, LA 71301-6929

Phone

(318) 448-3848

Fax

(318) 448-3953

NPI assigned

Jan 28, 2006

Last updated

Aug 22, 2020By 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

Mrs. Stacey Debevec, LOTR

Title

Executive Director

Phone

(318) 448-3848

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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.

• Renata Pilatova, M.D.

  • Pediatrics Physician
  • Alexandria, LA
  • NPI 1356331458
  NPD (past)

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

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801867833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 JACKSON ST",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713016929",
            "telephone_number": "318-448-3848",
            "fax_number": "318-448-3953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 JACKSON ST",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713016929",
            "telephone_number": "318-448-3848",
            "fax_number": "318-448-3953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEBEVEC",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "318-448-3848",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LOTR"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1462195",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1698202",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Elise Pearson, BA
• Austin M Peavy, PHARMD
• Pecan Grove Training Center
• Pecan Park Pharmacy
• Pediatric Heart Center a Medical, LLC
• Peepers Optical, LLC
• Austin Peery, DOCTOR OF OPTOMETRY
• Pelican State Foot & Ankle Care LLC
• Christy Pennison, LPC-S
• Katerrio Pennywell

• Developmental Disabilities Clinic/Center in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Developmental Disabilities Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.