Active NPI
Lisa M Alley, ATC, LAT
- Athletic Trainer
- Columbia, MD
National Provider Identifier
1033560438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- A0000687
- Practice address
- 5500 Knoll North Dr
Columbia, MD 21045-2370 - Phone
- (443) 542-0062
- NPI assigned
- Jun 27, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | A0000687 | MD | Primary |
Addresses
Primary practice location
5500 Knoll North Dr
Columbia, MD 21045-2370
Mailing address
250 Charita Way
Severna Park, MD 21146-4004
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A0000687 | MD | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466985600000",
"number": "1033560438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 CHARITA WAY",
"city": "SEVERNA PARK",
"state": "MD",
"postal_code": "211464004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5500 KNOLL NORTH DR",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210452370",
"telephone_number": "443-542-0062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEY",
"first_name": "LISA",
"middle_name": "M",
"credential": "ATC, LAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-27",
"last_updated": "2016-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MD",
"license": "A0000687",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.