Active NPI
Lisa Dawn Rennie, M.S.,P.T.
- Physical Therapist
- St Petersburg, FL
National Provider Identifier
1053459131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 18063
- Practice address
- 801 6TH St S
St Petersburg, FL 33701-4816 - Phone
- (727) 767-8096
- Fax
- (727) 767-4004
- NPI assigned
- Feb 2, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 18063 | FL | Primary |
Addresses
Primary practice location
801 6TH St S
St Petersburg, FL 33701-4816
Mailing address
10293 137TH LN
Largo, FL 33774-5321
Phone (727) 543-5845
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 18063 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053459131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10293 137TH LN",
"city": "LARGO",
"state": "FL",
"postal_code": "337745321",
"telephone_number": "727-543-5845",
"fax_number": "727-595-0592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 6TH ST S",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337014816",
"telephone_number": "727-767-8096",
"fax_number": "727-767-4004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENNIE",
"first_name": "LISA",
"middle_name": "DAWN",
"name_prefix": "Mrs.",
"credential": "M.S.,P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT 18063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- 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.