Lisa M Nolden, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160004668 Issued in IL

Practice address

1663 Belvidere Rd
Belvidere, IL 61008-9306

Phone

(815) 544-0040

Fax

(815) 544-0048

NPI assigned

Aug 2, 2010

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Physicians Immediate Care LTD

  • Urgent Care Clinic/Center
  • Rockford, IL
  • NPI 1528046323
  NPD (past)
• Physicians Immediate Care North Chicago LLC

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1205814118
  NPD (past)

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1093029092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2176",
            "address_2": "DEPT 5389",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532012176",
            "telephone_number": "815-713-2600",
            "fax_number": "815-654-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1663 BELVIDERE RD",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610089306",
            "telephone_number": "815-544-0040",
            "fax_number": "815-544-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLDEN",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-02",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160004668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "769380",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL LICENSE",
            "identifier": "160004668",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Molinari, MD
• Christine M Moore, DPT
• Divyesh N Morker, MD
• Sara M Munwam, LSW
• New Millennium Medical, LTD.
• Northwest Suburban Community Hospital
• Northwoods Care Centre
• Mark Elton Lao Ong
• Optical Outlet of Belvider
• Arturo Ortega Jr., PHARM D

• All providers in Belvidere, IL
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; 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.