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1285006312 NPI number — LEAH ELISE LAGASSE DPT

NPI Number: 1285006312
Health Care Provider/Practitioner: LEAH ELISE LAGASSE DPT

Information about “1285006312” NPI (LEAH ELISE LAGASSE DPT) exists in 1285006312 in HTML format HTML  |  1285006312 in plain Text format TXT  |  1285006312 in PDF (Portable Document Format) PDF  |  1285006312 in an XML format XML  formats.

NPI Number : 1285006312 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1285006312",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LAGASSE",
    "FirstName": "LEAH",
    "MiddleName": "ELISE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MCMILLION",
    "OtherFirstName": "LEAH",
    "OtherMiddleName": "ELISE",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "DPT",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "501 FOREST LANE",
    "SecondLineMailingAddress": "SUITE A",
    "MailingAddressCityName": "CLEMSON",
    "MailingAddressStateName": "SC",
    "MailingAddressPostalCode": "29631",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "864-654-2001",
    "MailingAddressFaxNumber": "800-305-7112",
    "FirstLinePracticeLocationAddress": "9251 STONESTREET RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LOUISVILLE",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "40272-2858",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "877-407-3422",
    "PracticeLocationAddressFaxNumber": "877-407-4329",
    "EnumerationDate": "10/28/2015",
    "LastUpdateDate": "04/30/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "PT4089",
          "LicenseNumberStateCode": "HI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "9232",
          "LicenseNumberStateCode": "SC",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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