Jerry W Paige, BS

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

00457 Issued in LA

Practice address

204 Clinic Dr
Donaldsonville, LA 70346

Phone

(225) 473-4719

Fax

(225) 473-4719

NPI assigned

Oct 5, 2005

Last updated

Jun 16, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

State licenses

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

• Ascension Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Donaldsonville, LA
  • NPI 1033259486
  Authorized official Same address or phone

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1831186691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 CLINIC DR",
            "city": "DONALDSONVILLE",
            "state": "LA",
            "postal_code": "70346",
            "telephone_number": "225-473-4719",
            "fax_number": "225-473-4719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 CLINIC DR",
            "city": "DONALDSONVILLE",
            "state": "LA",
            "postal_code": "70346",
            "telephone_number": "225-473-4719",
            "fax_number": "225-473-4719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAIGE",
        "first_name": "JERRY",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "00457",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "LA",
            "license": "00457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650013713",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nagaratna Reddy M.D (Reddy Family Medical Clinic)
• Nagaratna Reddy M.D (Reddy Family Medical Clinic)
• Nagaratna Reddy MD (Reddy Family Medical Clinic)
• Helen Nguyen
• Glen S Padgett, D.D.S.
• Kate Palmisano
• Shelly Pendergrass, PA-C
• Lauren Penn, ATC, LAT
• Jay M Perniciaro, DC
• Megan Rose Petty

• Physical Therapy Clinic/Center in Donaldsonville, LA
• Providers in Donaldsonville, LA by specialty
• Physical Therapy Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.