Caroline Lisee, MED, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0126002369 Issued in VA

Practice address

1 Im Sports Cir
308 W. Circle Drive
East Lansing, MI 48824-1049

Phone

(862) 432-2171

NPI assigned

Jun 29, 2016

Sex

Female

Sole proprietor

No

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

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1083065213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105A STRIBLING AVE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229032940",
            "telephone_number": "862-432-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 IM SPORTS CIR",
            "address_2": "308 W. CIRCLE DRIVE",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488241049",
            "telephone_number": "862-432-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISEE",
        "first_name": "CAROLINE",
        "credential": "MED, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126002369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Laurene Kocis Liska, DO
• Micah Lissy, MD
• Karen L Litos, PT, DPT, WCS
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• Athletic Trainer in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Athletic Trainer in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.