Lisa Haverkamp, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070022153 Issued in IL

Practice address

4112 46TH Ave
Rock Island, IL 61201-7166

Phone

(309) 779-2828

NPI assigned

Sep 30, 2016

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

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.

• Trinity Medical Center

  • Emergency Medicine Physician
  • Rock Island, IL
  • NPI 1568414134
  NPD (past)

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475193600000",
    "number": "1104375245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4112 46TH AVE",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 46TH AVE",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017166",
            "telephone_number": "309-779-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERKAMP",
        "first_name": "LISA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-30",
        "last_updated": "2016-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070022153",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "081881",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Anne Harris
• David Hartsuch, MD
• Stacie Meri Hatfield, ED.D., CCC-SLP
• Betty Hatley
• Haven Chiropractic, PLLC
• Stacy Hayes Kane, MSW
• Martha S Hayes, OT
• Rebecca M Hayes, MD
• Jill K Hays, O.D.
• Christiana A Headley, LPC

• Physical Therapist in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.