360 Therapy, LLC
Organization Active NPI Physical Therapy Clinic/Center · Albany, LA
NPI 1992199657 · NPPES record last updated Jan 18, 2022
Key facts
- NPI
- 1992199657
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- License
- A5108 (LA)
- Legal business name
- 360 THERAPY, LLC
- Practice address
- 19089 Florida Blvd
Albany, LA 70711-3603 - Phone
- (225) 209-7140
- Fax
- (225) 567-6847
- NPI assigned
- Mar 20, 2015
- Organization subpart
- No
Authorized official
- Name
- Melissa F Tate, PT
- Title
- Owner
- Phone
- (225) 209-7140
Practitioners 16
-
Anthony Lamarca, DPT
-
Erin Taylor Trumbach, DPT
-
David Michael Hebert, PTA
-
Sydney Priola, DPT
-
Brittany Lynn Brumfield, FNP-C
-
Jacquelynn Hebert, PTA
-
Erin L Hurt, MSN, RN, APRN, CPNP
-
Kimberly Renee Manina, FNP-C
-
Magahn Ward Stanga, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160527000369 | LA | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 7416247713 |
Receives reassigned benefits from 3 practitioners Practice locations: Albany, LA; Loranger, LA; Kentwood, LA |
National Provider Directory
Locations
29644 S Montpelier Rd
#A
Albany, LA 70711
706 Avenue G
Ste 2
Kentwood, LA 70444
Phone (985) 614-5000
54033 Highway 1062
#B
Loranger, LA 70446
Phone (225) 209-7140
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | A5108 | LA | Yes |
Addresses
Primary practice location
19089 Florida Blvd
Albany, LA 70711-3603
Mailing address
PO Box 1536
Albany, LA 70711-1536
Phone (225) 209-7140
Other practice location 1
54033 Highway 1062 Ste B
Loranger, LA 70446-3538
Phone (225) 209-7140
Other names
- 360 Therapy
Other providers in Albany, LA
All providers in Albany, LA · Physical Therapy Clinic/Center in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2022. 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.