Lisa Rosen

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501019255 Issued in MI

Practice address

4289 Klais Dr
Clarkston, MI 48348-2369

Phone

(254) 319-4297

NPI assigned

Oct 25, 2016

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

Enrolled in TX

Enrollment records 1

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.

• Rosen Physical Therapy Inc

  • Physical Therapist
  • San Antonio, TX
  • NPI 1063099539
  Medicare reassignment NPD Authorized official
• Legacy Healthcare Services Inc.

  • Physical Therapist
  • Cedar Park, TX
  • NPI 1871132357
  Medicare reassignment NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489
  NPD

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1093267106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1663 STEPHENSON HWY",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4289 KLAIS DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483482369",
            "telephone_number": "254-319-4297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-25",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lateshia Katina Rogers, LLC
• Kevin Rohner
• Roman Franklin MD PC
• Tara Suzanne Rood, RD
• Natalie Warner Rookus
• Lawrence Brent Rosenberg, SLP
• Shay N Rosenfeld, D.P.M.
• Maria Elizabeth Roy, RN, BS
• Rebecca Roy
• Tiffany A Roy, MA, LLPC, NCC

• Physical Therapist in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.