Larissa Gizelle Neal

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

2305204903 Issued in VA

Practice address

1640 Redstone Center Dr
200
Park City, UT 84098-7605

Phone

(888) 800-8744

NPI assigned

May 26, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1211760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211760000000",
    "number": "1053579250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44863 MILESTONE SQ",
            "address_2": "302",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201474203",
            "telephone_number": "703-729-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 REDSTONE CENTER DR",
            "address_2": "200",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840987605",
            "telephone_number": "888-800-8744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "LARISSA",
        "middle_name": "GIZELLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-26",
        "last_updated": "2008-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "VA",
            "license": "2305204903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Physical Therapist in Park City, UT
• Providers in Park City, UT by specialty
• Geriatric Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2008; 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.