Lisa Folsom, PHYSICAL THERAPY

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501005065 Issued in MI

Practice address

9935 Red Arrow Hwy
Bridgman, MI 49106-9002

Phone

(269) 465-3017

NPI assigned

Apr 15, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Physical Therapy Services,LLCGroup PAC ID 4486842325, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Summit Physical Therapy Services,LLC

  • Physical Therapist
  • Waterloo, IL
  • NPI 1588980247

  IL, Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1523750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1093202145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 126",
            "city": "HARBERT",
            "state": "MI",
            "postal_code": "491150126",
            "telephone_number": "312-369-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9935 RED ARROW HWY",
            "city": "BRIDGMAN",
            "state": "MI",
            "postal_code": "491069002",
            "telephone_number": "269-465-3017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLSOM",
        "first_name": "LISA",
        "credential": "PHYSICAL THERAPY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-15",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501005065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "5501005065",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Destiny Cole
• Country Manor Care Center
• Dockerty Health Care Services Inc
• Dr. Bresler and Asso PC
• Devin Emens
• John Harris Foti, D.C.
• Mary E Good, PA-C
• Daniel L Hayward, MD
• Cynthia Kay Hildebrandt
• Jorge Arturo Huaringa, RN BSN

• All providers in Bridgman, MI
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.