Organization Active NPI

Brignac Physical Therapy, LLC

  • Clinic/Center
  • Gramercy, LA
National Provider Identifier
1811049356
Registry record updated Nov 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
BRIGNAC PHYSICAL THERAPY, LLC
Practice address
1732 Deroche Circle
Suite B
Gramercy, LA 70052
Phone
(225) 869-0389
Fax
(225) 869-0271
NPI assigned
Jan 17, 2007
Last updated
Nov 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2015

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

Authorized official

Name
Mrs. Chantel Brignac, P.T., A.T.C.NPI 1184775603
Title
Physical Therapist / Owner
Phone
(225) 869-0389

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X LA Primary

Addresses

Primary practice location

1732 Deroche Circle
Suite B
Gramercy, LA 70052

Mailing address

1732 Deroche Circle
Suite B
Gramercy, LA 70052
Phone (225) 869-0389

Other names 1

  • Livingston Rehab & Wellness Center Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050203000833 LA Part B Supplier - Clinic/Group Practice 6002867330 Receives reassigned benefits from 1 practitioner
Practice locations: Gramercy, LA

National Provider Directory

National Provider Directory

Locations

1732 Deroche Cir
#B
Gramercy, LA 70052
Phone (225) 868-0309

10900 Highway 3125
Ste D
Lutcher, LA 70071
Phone (225) 869-0389

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448841600000",
    "number": "1811049356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1732 DEROCHE CIRCLE",
            "address_2": "SUITE B",
            "city": "GRAMERCY",
            "state": "LA",
            "postal_code": "70052",
            "telephone_number": "225-869-0389",
            "fax_number": "225-869-0271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1732 DEROCHE CIRCLE",
            "address_2": "SUITE B",
            "city": "GRAMERCY",
            "state": "LA",
            "postal_code": "70052",
            "telephone_number": "225-869-0389",
            "fax_number": "225-869-0271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGNAC PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2015-11-30",
        "status": "A",
        "authorized_official_last_name": "BRIGNAC",
        "authorized_official_first_name": "CHANTEL",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST / OWNER",
        "authorized_official_telephone_number": "225-869-0389",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "P.T., A.T.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Livingston Rehab & Wellness Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Gramercy, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; 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.