Individual provider Active NPI

Tad Landry, DPT

  • Physical Therapist
  • Lake Charles, LA
National Provider Identifier
1902152853
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
08281 Issued in LA
Practice address
208 W McNeese St
Lake Charles, LA 70605-5638
Phone
(337) 824-5488
Fax
(337) 824-5494
NPI assigned
Jul 30, 2012
Last updated
Jul 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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 08281 LA Primary

Addresses

Primary practice location

208 W McNeese St
Lake Charles, LA 70605-5638

Mailing address

208 W McNeese St
Lake Charles, LA 70605-5638
Phone (337) 824-5488

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121019000120 LA Practitioner - Physical Therapist in Private Practice 7810147378 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Louisiana Sports and Rehabilitation Center, LLCGroup PAC ID 5890854434, 11 clinicians

Practice addresses (Care Compare)

208 W McNeese St
Lake Charles, LA 70605-5638
Phone (337) 475-1053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thibodeaux, Albro & Touchet Therapy Group, LLC Physical Therapist CurrentSince Jan 1, 2018 Accepting new patients
Calcasieu Therapy Group LLC Physical Therapist CurrentSince Jan 1, 2014 Accepting new patients
Iowa Therapy Group LLC Physical Therapist CurrentSince Jan 1, 2016 Accepting new patients
Southwest Louisiana Sports and Rehabilitation Center, LLC Physical Therapist CurrentSince Aug 1, 2012 Accepting new patients
Kinder Therapy Group, LLC Physical Therapist PastSince Nov 26, 2023 Accepting new patients

Locations

1113 E Northern Ave
Crowley, LA 70526
Phone (337) 783-5577

605 N Thomson Ave
Iowa, LA 70647
Phone (337) 582-4242

1322 Elton Rd
Ste 1
Jennings, LA 70546

1322 Elton Rd
Ste I
Jennings, LA 70546
Phone (337) 616-8099

208 W McNeese St
Lake Charles, LA 70605
Phone (337) 475-1053

486 N Highway 171
Moss Bluff, LA 70611
Phone (337) 217-0997

900 Cypress St
Sulphur, LA 70663
Phone (337) 528-2828

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1902152853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 W MCNEESE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055638",
            "telephone_number": "337-824-5488",
            "fax_number": "337-824-5494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 W MCNEESE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055638",
            "telephone_number": "337-824-5488",
            "fax_number": "337-824-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "TAD",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-30",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "08281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; 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.