Lisa Marie Roper, B.S, ATC, LAT

Primary specialty

Respiratory/Developmental/Rehabilitative Specialist/TechnologistTaxonomy code 225500000X

License

AT-374 Issued in ID

Practice address

1900 W Pine Ave
Meridian, ID 83642-1961

Phone

(208) 350-4160

Fax

(208) 350-4178

NPI assigned

Jun 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Lisa Marie White Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480723200000",
    "number": "1063455608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4075 N TALLGRASS AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836462613",
            "telephone_number": "208-936-5445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W PINE AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421961",
            "telephone_number": "208-350-4160",
            "fax_number": "208-350-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROPER",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "B.S, ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2016-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OR",
            "license": "AT-AT-148663",
            "primary": false
        },
        {
            "code": "225500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": "ID",
            "license": "AT-374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AT-374",
            "identifier": "1063455608",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "WHITE",
            "middle_name": "MARIE",
            "credential": "B.S, ATC/LAT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Respiratory/Developmental/Rehabilitative Specialist/Technologist in Meridian, ID
• Providers in Meridian, ID by specialty
• Respiratory/Developmental/Rehabilitative Specialist/Technologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.

Verify at the official NPI Registry.