John Nicholas Hodge III, PTA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

2106291 Issued in TX

Practice address

121 Carroll St
Shreveport, LA 71105

Phone

(318) 560-4326

NPI assigned

Aug 23, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Trey Hodge Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503446400000",
    "number": "1811414642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CARROLL ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 CARROLL ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71105",
            "telephone_number": "318-560-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGE",
        "first_name": "JOHN",
        "middle_name": "NICHOLAS",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-23",
        "last_updated": "2017-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "2106291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TREY",
            "last_name": "HODGE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Stanley Hoang, MD
• James C Hobley, M.D.
• Emily R Hobson, M.D.
• Ashley Hall Hochstetler, DPT
• Christia A Hockaday, MHP
• Shaqwana Hodge
• Janet L Hoefler, RN, CDE
• Madeline Hoeppner
• Grace Hoffman, PHARMD.
• Alana Marie Hofmann, MD

• Physical Medicine & Rehabilitation Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physical Medicine & Rehabilitation Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2017; 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.