Individual provider Active NPI

Lisa Ann-Longobardo Plesa, D.C.

  • Chiropractor
  • Indian Trail, NC
National Provider Identifier
1114171295
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
NC3890 Issued in NC
Practice address
14015 Independence Blvd Ste D
Indian Trail, NC 28079-9668
Phone
(704) 882-1488
Fax
(704) 882-1448
NPI assigned
Nov 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NC3890 NC Primary
Chiropractor 111N00000X CHIR008324 GA

Addresses

Primary practice location

14015 Independence Blvd Ste D
Indian Trail, NC 28079-9668

Mailing address

14015 Independence Blvd Ste D
Indian Trail, NC 28079-9668

Other identifiers 1

IdentifierTypeStateIssuer
2457502OtherNCMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR008324GAMDChiropractor
NC3890NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Indian Trail Specific Chiropractic Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1226793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1114171295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14015 INDEPENDENCE BLVD STE D",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280799668",
            "fax_number": "704-882-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14015 INDEPENDENCE BLVD STE D",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280799668",
            "telephone_number": "704-882-1488",
            "fax_number": "704-882-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLESA",
        "first_name": "LISA",
        "middle_name": "ANN-LONGOBARDO",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-16",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "NC3890",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008324",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2457502",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Trail, NC

Sources for this page

  • 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.