Lisa Lajune Smith, PT, M.ED.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2674 Issued in GA

Practice address

1255 Highway 54 W
Fayetteville, GA 30214-4526

Phone

(770) 719-7183

Fax

(770) 719-7189

NPI assigned

Mar 29, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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 names 1

• Lisa McGhee Smith Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003936790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WYNGATE WAY",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302152458",
            "telephone_number": "770-719-7183",
            "fax_number": "770-719-7189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 HIGHWAY 54 W",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144526",
            "telephone_number": "770-719-7183",
            "fax_number": "770-719-7189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LISA",
        "middle_name": "LAJUNE",
        "name_prefix": "Mrs.",
        "credential": "PT, M.ED.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "2674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "SMITH",
            "middle_name": "MCGHEE",
            "credential": "PT, M.ED",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ida Smith, NP
• Jennifer Smith
• Jerikka Smith
• Karen Lynn Smith, R.D.
• Laura Marie Carn Smith, DMD
• Marquetta Elaine Smith, MSSW, PCS, CCC
• Sharon Smith, RBT
• Smith, Spelios and Associates LLC
• Stacy G Smith, DMD
• Tasha Lynne Smith, PTA

• Physical Therapist in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Physical Therapist in Georgia

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

Verify at the official NPI Registry.