FUNCTION FIRST PHYSICAL THERAPY, LLC (NPI# 1114430071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114430071 |
| Entity Type | Organization |
| Organization Name | FUNCTION FIRST PHYSICAL THERAPY, LLC |
| Practice Address |
7607 Fern Ave Ste 704 Shreveport LA 71105-5744 |
| Practice Telephone | 3188281450 |
| Practice Fax Number | 3188282697 |
| Mailing Telephone | 3188281450 |
| Mailing Fax Number | 3188281450 |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2020-07-15 |
| Authorized Official Name | DR. GREGORY KYLE KINTZING (CEO) |
| Authorized Official Telephone | 3188281450 |
| Authorized Official Credential | DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | 08117 | LA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| Y | 2251G0304X |
Physical Therapist Specialization: Geriatrics |
08117 | LA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2122 Airline Dr Ste 200, Bossier City, LA 711113270 | 3188281450 | 3188282697 |
| Street Address |
7607 FERN AVE STE 704 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-5744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659781235 | Dawn Guice | Speech-Language Pathologist | 7607 Fern Ave Ste 704, Shreveport, LA 71105-5744 | 2014-05-05 |
| 1780153023 | Latisha Levelma Williams | Physical Therapist | 7607 Fern Ave Ste 704, Shreveport, LA 71105-5744 | 2018-11-15 |
| 1235636226 | Ernest Carpenter IIi | Occupational Therapist | 7607 Fern Ave Ste 704, Shreveport, LA 71105-5744 | 2018-04-07 |
| 1063919058 | Daryl Tuminello | Speech-Language Pathologist | 7607 Fern Ave Ste 704, Shreveport, LA 71105-5744 | 2018-04-07 |
| 1316303399 | Gregory Kyle Kintzing | Physical Therapist | 7607 Fern Ave Ste 704, Shreveport, LA 71105-5744 | 2016-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
| 1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
| Find all providers in zip 71105 | ||||
| Taxonomy Code | 2251G0304X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Geriatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255840484 | Armafe Teresita Veneracion | Physical Therapist | 9906 Red Haw Ln, Shreveport, LA 71115-9304 | 2017-09-20 |
| 1679197784 | Morgan E Goodwin | Physical Therapist | 8660 Fern Ave Ste 160, Shreveport, LA 71105-5694 | 2020-06-04 |
| 1912472911 | Emily Abendroth | Physical Therapist | 3050 Baird Rd, Shreveport, LA 71118-3818 | 2018-10-05 |
| 1538543467 | Christopher S Berry | Physical Therapist | 8660 Fern Ave Ste 160, Shreveport, LA 71105-5694 | 2015-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497132161 | Elisa Deann Brown | Physical Therapist | 2301 Severn Ave, B309, Metairie, LA 70001-1949 | 2015-05-01 |
| 1407405269 | Movement Specialists Physical Therapy, LLC | Physical Therapist | 4532 W Napoleon Ave Ste 101, Metairie, LA 70001-2469 | 2019-09-05 |
| 1346807260 | John Donald Miller Jr. | Physical Therapist | 50 Pinecrest Dr, Pineville, LA 71360-4283 | 2019-05-27 |
| 1104345206 | Jeffrey M Phillips | Physical Therapist | 2906 Plantation Dr, Bossier City, LA 71111-5851 | 2017-09-11 |
| 1730585787 | Gerald Delacruz | Physical Therapist | 8128 Florida Blvd, Denham Springs, LA 70726-7865 | 2014-11-18 |
| City | SHREVEPORT |
| Zip Code | 71105 |
Please comment or provide details below to improve the information on FUNCTION FIRST PHYSICAL THERAPY, LLC.
| 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.