TRI-STATE PHYSICAL THERAPY #5 INC (NPI# 1982655130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982655130 |
| Entity Type | Organization |
| Organization Name | TRI-STATE PHYSICAL THERAPY #5 INC |
| Practice Address |
2120 Bert Kouns Loop Suite B Shreveport LA 71118-3351 |
| Mailing Address |
2820 Hearne Ave Shreveport LA 71103-3934 |
| Practice Telephone | 3186684156 |
| Practice Fax Number | 3186879755 |
| Mailing Telephone | 3186317999 |
| Mailing Fax Number | 3186319528 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DAN B TURNER (PRESIDENT/ADMINISTRATOR) |
| Authorized Official Telephone | 3186317999 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Street Address |
2120 BERT KOUNS LOOP SUITE B |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71118-3351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477512309 | Kirit S Patel | Internal Medicine | 2120 Bert Kouns Loop, Ste F, Shreveport, LA 71118-3351 | 2006-03-20 |
| 1487826566 | Danielle V Mcrae | Physical Therapist | 2120 Bert Kouns Loop, Suite B, Shreveport, LA 71118-3351 | 2008-03-28 |
| 1851393029 | Alfred W. Hathorn Jr. | Specialist | 2120 Bert Kouns Loop, Ste L, Shreveport, LA 71118-3355 | 2005-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720620784 | Wk Center for Pediatric Gastroenterology | Pediatrics | Wk Center for Pediatric Gastroenterology, 2530 Bert Kouns Industrial Loop, Ste 113, Shreveport, LA 71118 | 2019-10-11 |
| 1306302443 | Diamond Marie Willis | Case Manager/Care Coordinator | 9403 Mansfield Rd., Shreveport, LA 71118 | 2019-02-13 |
| 1194224469 | Latosa Hall | Case Manager/Care Coordinator | 9007 Letha Loop, Shreveport, LA 71118 | 2018-02-01 |
| 1902321623 | Bersheika Lashay Player | Counselor | 9403 Mansfield Road, Shreveport, LA 71118 | 2017-08-03 |
| 1518487149 | Clarke Jackson | Case Manager/Care Coordinator | 9730 Baird Rd Apt 2310, Shreveport, LA 71118 | 2017-06-24 |
| 1770010449 | Darrie'l Smith | Counselor | 2715 Mackey, Shreveport, LA 71118 | 2017-05-12 |
| 1760917041 | Delilah Wells | Case Manager/Care Coordinator | 9005 Walker Rd Apt 722, Shreveport, LA 71118 | 2017-04-25 |
| 1790229664 | We Care Transporttion Services LLC | Secured Medical Transport (VAN) | 2529 Summer Grove Dr, Shreveport, LA 71118 | 2016-12-13 |
| 1063955128 | Commanisha Smith | Social Worker | 2715 Mackey Place, Shreveport, LA 71118 | 2016-11-22 |
| 1023560802 | Yasmin Newman | Counselor | 9812 West Trails End, Shreveport, LA 71118 | 2016-10-27 |
| Find all providers in zip 71118 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972142024 | Resilience Concierge Physical Therapy | Clinic/Center | 609 Woodmere Dr, Shreveport, LA 71115-3815 | 2020-01-06 |
| 1104385095 | Injurymd, LLC | Clinic/Center | 1715 Marycrest Ave Ste 200, Shreveport, LA 71101-5074 | 2019-03-19 |
| 1962825331 | Red River Recovery & Physical Therapy | Clinic/Center | 2539 E. 70th St, Shreveport, LA 71105 | 2014-01-21 |
| 1538451851 | Specialists Hospital of Louisiana | Clinic/Center | 1500 Line Ave Ste 105, Shreveport, LA 71101-4639 | 2011-05-04 |
| 1326099540 | Tri-state Physical Therapy Number 1 Inc | Clinic/Center | 8660 Fern Ave Ste 160, Shreveport, LA 71105-5694 | 2006-05-12 |
| 1053362202 | Tri-state Physical Therapy #6 Inc | Clinic/Center | 1610 E Bert Kouns Loop, Shreveport, LA 71105-5717 | 2006-05-12 |
| 1811133093 | Bayou State Therapy | Clinic/Center | 457 Ashley Ridge Blvd Ste B, Shreveport, LA 71106-7229 | 2008-12-18 |
| 1477709681 | Brewer Physical Therapy & Associates LLC | Clinic/Center | 663 Jordan St, Shreveport, LA 71101-4748 | 2008-08-07 |
| 1275790396 | Select Physical Therapy Holdings Inc | Clinic/Center | 820 Jordan St, Ste 370, Shreveport, LA 71101-4518 | 2008-05-16 |
| 1386705036 | Promoting Livelihood and Ability In Youth Physical Therapy LLC | Clinic/Center | 1800 Buckner St, Suite C-200, Shreveport, LA 71101-4440 | 2006-12-13 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71118 |
Please comment or provide details below to improve the information on TRI-STATE PHYSICAL THERAPY #5 INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.