Active NPI
Alyssa Denee Patterson, PTA
- Physical Therapy Assistant
- Shreveport, LA
National Provider Identifier
1831745140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A10030
- Practice address
- 650 Olive St
Shreveport, LA 71104-2210 - Phone
- (318) 302-6000
- Fax
- (318) 302-6001
- NPI assigned
- Aug 13, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A10030 | LA | Primary |
Addresses
Primary practice location
650 Olive St
Shreveport, LA 71104-2210
Mailing address
13756 Highway 146
Arcadia, LA 71001-5117
Phone (318) 294-4418
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A10030 | Other | LA | LOUISIANA PHYSICAL THERAPY BOARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A10030 | LA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riley Physical Therapy, Inc | Current | Accepting new patients |
Locations
650 Olive St
Shreveport, LA 71104
Phone (318) 302-6000
Organizations & group practices 1
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.
-
- Physical Therapist
- Shreveport, LA
- NPI 1356814826
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565654400000",
"number": "1831745140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13756 HIGHWAY 146",
"city": "ARCADIA",
"state": "LA",
"postal_code": "710015117",
"telephone_number": "318-294-4418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 OLIVE ST",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711042210",
"telephone_number": "318-302-6000",
"fax_number": "318-302-6001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "ALYSSA",
"middle_name": "DENEE",
"name_prefix": "Miss",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-13",
"last_updated": "2019-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "LA",
"license": "A10030",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LOUISIANA PHYSICAL THERAPY BOARD",
"identifier": "A10030",
"state": "LA"
}
],
"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 Aug 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.