Courtney St. Pierre Mistretta, DPT
Individual provider Active NPI Physical Therapist · Vacherie, LA
NPI 1922779461 · NPPES record last updated Sep 27, 2021
Key facts
- NPI
- 1922779461
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 10929 (LA)
- Practice address
- 22128 Hwy 20
Vacherie, LA 70090 - Phone
- (225) 265-2400
- NPI assigned
- Sep 24, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211007002952 | LA | Practitioner - Physical Therapist in Private Practice | 9739587585 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10929 | LA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Accelerated Rehab and Sports Medicine, LLC | Physical Therapist | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10929 | LA | Yes |
Addresses
Primary practice location
22128 Hwy 20
Vacherie, LA 70090
Mailing address
PO Box 178
Vacherie, LA 70090-0178
Phone (225) 265-2400
Other providers in Vacherie, LA
- Amy H Lagraize
- Lynsey Landry
- Emily Ann Earline Lassere
- Denise Louque
- Albert Joseph Mahler Jr.
- Keishea Mitchell
- Tanisha Moore
- Nephrology Associates
- New Hope Adult Day Health Care, Inc
- Michael Dirk Ory
All providers in Vacherie, LA · Physical Therapist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.