Organization Active NPI

Rolling Rehab LLC

  • Physical Therapist
  • Benton, LA
National Provider Identifier
1861404683
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
01146 Issued in LA
Legal business name
ROLLING REHAB LLC
Practice address
115 Hunt Rd
Benton, LA 71006-3469
Phone
(318) 230-2537
NPI assigned
Aug 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Shanna Dion Johnson, MS,PTNPI 1932327608
Title
Physical Therapist
Phone
(318) 965-3990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 01146 LA Primary

Addresses

Primary practice location

115 Hunt Rd
Benton, LA 71006-3469

Mailing address

115 Hunt Rd
Benton, LA 71006-3469
Phone (318) 965-3990

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070510000208 LA Part B Supplier - Clinic/Group Practice 5092710772 Receives reassigned benefits from 1 practitioner
Practice locations: Benton, LA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861404683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 HUNT RD",
            "city": "BENTON",
            "state": "LA",
            "postal_code": "710063469",
            "telephone_number": "318-965-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 HUNT RD",
            "city": "BENTON",
            "state": "LA",
            "postal_code": "710063469",
            "telephone_number": "318-230-2537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROLLING REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SHANNA",
        "authorized_official_middle_name": "DION",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "318-965-3990",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS,PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "01146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.