Lisa M Willer, MS PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501007693 Issued in MI

Practice address

5709 Saint Joseph Ave
Stevensville, MI 49127-1239

Phone

(269) 556-0930

Fax

(269) 429-0114

NPI assigned

Aug 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southwestern Medical Clinic PC

  • Specialist
  • Niles, MI
  • NPI 1518022144
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301011200000",
    "number": "1003822792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 458",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491200458",
            "telephone_number": "269-556-0930",
            "fax_number": "269-429-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5709 SAINT JOSEPH AVE",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491271239",
            "telephone_number": "269-556-0930",
            "fax_number": "269-429-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLER",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "MS PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2011-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501007693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00330531",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Ann Walker, PA
• Jill S Wang, MD
• William H Ward, MD
• Richard A Watson
• Stephanie C Welch, PA
• Jennifer D Williams, MSN, FNP-BC
• Bradford Wilson, TLLP
• Kimber Wooten-Toering, D.C.
• William Keith Wooten, D.C.
• Samantha York

• All providers in Stevensville, MI
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; 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.