Carissa Lynn Esposito, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2023047928 Issued in MO

Practice address

908 E Harbour Towne Dr
Lake Ozark, MO 65049-7214

Phone

(630) 824-7754

NPI assigned

Dec 28, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1703721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1003685298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 WESTBOURNE AVE",
            "city": "SUGAR GROVE",
            "state": "IL",
            "postal_code": "605542201",
            "telephone_number": "630-824-7754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 E HARBOUR TOWNE DR",
            "city": "LAKE OZARK",
            "state": "MO",
            "postal_code": "650497214",
            "telephone_number": "630-824-7754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPOSITO",
        "first_name": "CARISSA",
        "middle_name": "LYNN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-28",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2023047928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randall Galen Drake, D.C.
• Mary Ann Duckworth
• Tiffany Duncan-Ash, LPC
• Cibele F.C. Elliott, LPC
• Embark by Calo
• Patricia J Evans, MA
• Brian Eveland, OD
• Allison Lynn Foster
• Kelly K Frisella, O.D.
• Nicole R Fuglsang, MA, LPC

• Physical Therapy Assistant in Lake Ozark, MO
• Providers in Lake Ozark, MO by specialty
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.

Verify at the official NPI Registry.