Resilience Concierge Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

RESILIENCE CONCIERGE PHYSICAL THERAPY

Practice address

609 Woodmere Dr
Shreveport, LA 71115-3815

Phone

(318) 471-3306

NPI assigned

Jan 6, 2020

Organization subpart

No

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

Authorized official

Name

Jared Roge, PT, DPT

Title

Owner/Physical Therapist

Phone

(318) 471-3306

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1972142024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 WOODMERE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711153815",
            "telephone_number": "318-471-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 WOODMERE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711153815",
            "telephone_number": "318-471-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENCE CONCIERGE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-06",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "ROGE",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "318-471-3306",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Shreveport, LA
• Providers in Shreveport, 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 Jan 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.