Active NPI
Lisa Kay Willis, PT
- Physical Therapist
- Troy, MO
National Provider Identifier
1003007451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2000154583
- Practice address
- 556 Aubuchon Rd
Troy, MO 63379-4338 - Phone
- (636) 338-4095
- NPI assigned
- Aug 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2000154583 | MO | Primary |
Addresses
Primary practice location
556 Aubuchon Rd
Troy, MO 63379-4338
Mailing address
556 Aubuchon Rd
Troy, MO 63379-4338
Phone (636) 338-4095
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000154583 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186531200000",
"number": "1003007451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "556 AUBUCHON RD",
"city": "TROY",
"state": "MO",
"postal_code": "633794338",
"telephone_number": "636-338-4095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "556 AUBUCHON RD",
"city": "TROY",
"state": "MO",
"postal_code": "633794338",
"telephone_number": "636-338-4095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "LISA",
"middle_name": "KAY",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-08",
"last_updated": "2007-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2000154583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.