Physical Therapy Incorporated

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PHYSICAL THERAPY INCORPORATED

Practice address

2601 Ferrand St
Monroe, LA 71201-3212

Phone

(318) 387-4973

Fax

(318) 322-4093

NPI assigned

May 1, 2006

Last updated

Oct 13, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elaine Boudreaux

Title

Office Manager

Phone

(318) 387-4973

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942267018. Details of each certification follow.

• CCN 196649 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 196649

Legal name

PHYSICAL THERAPY INCORPORATED

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Apr 27, 2007

Last certification

Jan 2, 2020

Ownership / control type

Proprietary

Facility address

2601 Ferrand Street
Monroe, LA 71201

Locations

Practitioners 4

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.

• Anjelique Via Liles, MPT

  • Physical Therapist
  • Monroe, LA
  • NPI 1194782276
  Medicare reassignment NPD
• Mary Angela Cox, PTA

  • Physical Therapy Assistant
  • Monroe, LA
  • NPI 1366400780
  NPD (past)
• Heather Brooks Harkness, PTA

  • Physical Therapy Assistant
  • Monroe, LA
  • NPI 1215265459
  NPD (past)
• Wendi Richardson, SPEECH-LANGUAGE PATH

  • Speech-Language Pathologist
  • West Monroe, LA
  • NPI 1689714594
  NPD (past)

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476316800000",
    "number": "1942267018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 FERRAND ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013212",
            "telephone_number": "318-387-4973",
            "fax_number": "318-322-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 FERRAND ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013212",
            "telephone_number": "318-387-4973",
            "fax_number": "318-322-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2016-10-13",
        "status": "A",
        "authorized_official_last_name": "BOUDREAUX",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "318-387-4973"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "LA",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Symphony Phillips, APRN
• Whitney Phipps
• PHM Corporation
• Phoenix Rise Therapeutic Group (A Place for Her)
• Physical Therapy in Motion, Inc.
• Physician Billing SFN
• Debbie Jean Pierce
• Debbie Marie Pierce
• Edward C Pierce, MD
• Loria Shela Pierce, LMFT

• Physical Therapy Clinic/Center in Monroe, LA
• Providers in Monroe, LA by specialty
• Physical Therapy Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.