Individual provider Active NPI

Kristen Locicero Glascock, PT, DPT

  • Physical Therapist
  • Baton Rouge, LA
National Provider Identifier
1922460765
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
08082 Issued in LA
Practice address
3403 Rue D Orleans
Baton Rouge, LA 70810-0430
Phone
(985) 351-7795
NPI assigned
Mar 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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 08082 LA Primary

Addresses

Primary practice location

3403 Rue D Orleans
Baton Rouge, LA 70810-0430

Mailing address

3403 Rue D Orleans
Baton Rouge, LA 70810-0430
Phone (985) 351-7795

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170215001025 LA Practitioner - Physical Therapist in Private Practice 9638453079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delta Physical Therapy LLCGroup PAC ID 0749564185, 4 clinicians

Practice addresses (Care Compare)

12110 S Harrells Ferry Rd
Baton Rouge, LA 70816-2426
Phone (225) 372-5008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Physical Therapy LLC Physical Therapist CurrentSince Jan 1, 2017 Accepting new patients

Locations

3854 American Way
Baton Rouge, LA 70816
Phone (225) 372-5008

12110 S Harrells Ferry Rd
Baton Rouge, LA 70816

12110 S Harrells Ferry Rd
Ste 200
Baton Rouge, LA 70816
Phone (225) 372-5008

1606 S Magnolia St
Ste C
Hammond, LA 70403

1606 S Magnolia St
Hammond, LA 70403
Phone (985) 340-4198

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": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1922460765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3403 RUE D ORLEANS",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708100430",
            "telephone_number": "985-351-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3403 RUE D ORLEANS",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708100430",
            "telephone_number": "985-351-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASCOCK",
        "first_name": "KRISTEN",
        "middle_name": "LOCICERO",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "08082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; 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.