Active NPI
Stanley E Powell, PT
- Physical Therapist
- Shreveport, LA
National Provider Identifier
1952436495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 00943R
- Practice address
- 8835 Line Ave Ste 100
Shreveport, LA 71106-6731 - Phone
- (318) 681-5633
- Fax
- (318) 681-5685
- NPI assigned
- Feb 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 00943R | LA | Primary |
Addresses
Primary practice location
8835 Line Ave Ste 100
Shreveport, LA 71106-6731
Mailing address
PO Box 5477
Shreveport, LA 71135-5477
Phone (318) 681-5633
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2140094 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00943R | LA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564358400000",
"number": "1952436495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5477",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711355477",
"telephone_number": "318-681-5633",
"fax_number": "318-681-5685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8835 LINE AVE STE 100",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711066731",
"telephone_number": "318-681-5633",
"fax_number": "318-681-5685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "STANLEY",
"middle_name": "E",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-23",
"last_updated": "2019-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "00943R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2140094",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.