Individual provider Active NPI

Lloyd Vale

  • Physical Therapist
  • Shreveport, LA
National Provider Identifier
1821485285
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
07484F Issued in LA
Practice address
111 Pantheon LN
Shreveport, LA 71115-4506
Phone
(318) 789-0596
NPI assigned
Apr 22, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 07484F LA Primary

Addresses

Primary practice location

111 Pantheon LN
Shreveport, LA 71115-4506

Mailing address

111 Pantheon LN
Shreveport, LA 71115-4506
Phone (318) 789-0596

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250906000887 LA Practitioner - Physical Therapist in Private Practice 5698277804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

111 Pantheon LN
Shreveport, LA 71115-4506

127 W Broad St
Suite 850
Lake Charles, LA 70601-4394

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07484FLAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Care Southeast LLC Physical Therapist CurrentSince Jul 22, 2025 Accepting new patients
Synergy Care Southeast, LLC Physical Therapist CurrentSince Jul 22, 2025 Accepting new patients

Locations

127 W Broad St
Ste 850
Lake Charles, LA 70601
Phone (337) 310-8500

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1821485285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 PANTHEON LN",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711154506",
            "telephone_number": "318-789-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 PANTHEON LN",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711154506",
            "telephone_number": "318-789-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALE",
        "first_name": "LLOYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-22",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "07484F",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.