Active NPI
Kiantre Robinson
- Recreation Therapist
- Bastrop, LA
National Provider Identifier
1992525943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- Practice address
- 4287 Petrus Ave
Bastrop, LA 71220-7424 - Phone
- (318) 350-8792
- NPI assigned
- Oct 15, 2024
- 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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | Primary |
Addresses
Primary practice location
4287 Petrus Ave
Bastrop, LA 71220-7424
Mailing address
4287 Petrus Ave
Bastrop, LA 71220-7424
Phone (318) 350-8792
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728950400000",
"number": "1992525943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4287 PETRUS AVE",
"city": "BASTROP",
"state": "LA",
"postal_code": "712207424",
"telephone_number": "318-350-8792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4287 PETRUS AVE",
"city": "BASTROP",
"state": "LA",
"postal_code": "712207424",
"telephone_number": "318-350-8792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBINSON",
"first_name": "KIANTRE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-10-15",
"last_updated": "2024-10-15",
"certification_date": "2024-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bastrop, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.