Individual provider Active NPI

Jalisa Lowe

  • Physical Therapist
  • Lakeland, FL
National Provider Identifier
1023776457
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT38091 Issued in FL
Practice address
4525 S Florida Ave Ste 25
Lakeland, FL 33813-2184
Phone
(863) 812-4065
NPI assigned
Dec 2, 2021
Last updated
Dec 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT38091 FL Primary

Addresses

Primary practice location

4525 S Florida Ave Ste 25
Lakeland, FL 33813-2184

Mailing address

21756 State Road 54 Ste 102
Lutz, FL 33549-2905

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211210001131 FL Practitioner - Physical Therapist in Private Practice 0446640155 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT38091FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Services of Flatiron PC Physical Therapist CurrentSince Feb 24, 2025 Accepting new patients
Optimal Performance and Physical Therapies Lakeland, LLC Physical Therapist CurrentSince Dec 6, 2021 Accepting new patients
Rebirth Pelvic Health and Physical Therapy Current Accepting new patients

Locations

4525 S Florida Ave
Ste 25
Lakeland, FL 33813
Phone (863) 812-4065

21756 State Road 54
Ste 102
Lutz, FL 33549
Phone (813) 279-6234

111 N Orange Ave
Ste 800
Orlando, FL 32801
Phone (212) 287-4257

138 5th Ave
Fl 2
New York, NY 10011
Phone (212) 287-4257

Networks

  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: jalisa.lowe.1@21622.direct.athenahealth.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1638403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1023776457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21756 STATE ROAD 54 STE 102",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335492905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 S FLORIDA AVE STE 25",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132184",
            "telephone_number": "863-812-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWE",
        "first_name": "JALISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-02",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT38091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.