Ellen Dean Pedeaux, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

09898 Issued in LA

Practice address

4970 Barksdale Blvd Ste 900
Bossier City, LA 71112-4677

Phone

(318) 747-8892

Fax

(318) 747-8893

NPI assigned

Jun 2, 2021

Last updated

Feb 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ellen Andries Dean Former name

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Brewer Physical Therapy & Associates LLC

  • Physical Therapy Clinic/Center
  • Shreveport, LA
  • NPI 1477709681
  Medicare reassignment NPD
• Casa Pediatric Care LLC

  dba Casa Pediatric Care

  • Speech-Language Pathologist
  • Springdale, AR
  • NPI 1346873007
  NPD (past)
• Select Physical Therapy Texas Limited Partnership

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Houston, TX
  • NPI 1356304323
  NPD (past)

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1962078709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "663 JORDAN ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014748",
            "telephone_number": "318-222-8892",
            "fax_number": "318-222-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4970 BARKSDALE BLVD STE 900",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711124677",
            "telephone_number": "318-747-8892",
            "fax_number": "318-747-8893"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Royal St",
            "address_purpose": "LOCATION",
            "city": "Natchitoches",
            "state": "LA",
            "postal_code": "714575709",
            "country_code": "US",
            "telephone_number": "318-210-6836",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "663 Jordan St",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711014748",
            "country_code": "US",
            "telephone_number": "318-222-8892 x1",
            "fax_number": "318-222-8893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDEAUX",
        "first_name": "ELLEN",
        "middle_name": "DEAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "09898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "DEAN",
            "middle_name": "ANDRIES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Jentry McClard Pearson, PT, DPT
• Kimberly Akers Pearson, PT, DPT
• Pediatric Dental Partners, LLP
• Mardosha Peek
• Tracie Pendarvis
• Daniel Ray Pennywell
• Crystal Peoples-Mims

• Physical Therapist in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.