Individual provider Active NPI

Lisa Ann Vizzacco, DC

  • Chiropractor
  • Cranston, RI
National Provider Identifier
1013947415
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DCP000363 Issued in RI
Practice address
1255 Oaklawn Ave Ste 2D
Cranston, RI 02920-2649
Phone
(401) 942-6020
Fax
(401) 942-6178
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DCP000363 RI Primary

Addresses

Primary practice location

1255 Oaklawn Ave Ste 2D
Cranston, RI 02920-2649

Mailing address

1255 Oaklawn Ave Ste 2D
Cranston, RI 02920-2649
Phone (401) 942-6020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120730000054 RI Practitioner - Chiropractic 8123284536 Practice locations: Cranston, RI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1255 Oaklawn Ave
Suite 2D
Cranston, RI 02920-2649
Phone (401) 942-6020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DCP000363RIMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1013947415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 OAKLAWN AVE STE 2D",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029202649",
            "telephone_number": "401-942-6020",
            "fax_number": "401-942-6178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 OAKLAWN AVE STE 2D",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029202649",
            "telephone_number": "401-942-6020",
            "fax_number": "401-942-6178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIZZACCO",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "RI",
            "license": "DCP000363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.