Individual provider Active NPI

Alyssa Denee Patterson, PTA

  • Physical Therapy Assistant
  • Shreveport, LA
National Provider Identifier
1831745140
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A10030 Issued in LA
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

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
A10030OtherLALOUISIANA 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

LicenseStateTypeSpecialty
A10030LAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Riley Physical Therapy, Inc CurrentSince Oct 1, 2019 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.

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.

Verify at the official NPI Registry.