Active NPI
Raymond Lolli
- Physical Therapist
- Fort Ashby, WV
National Provider Identifier
1124449566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 300
- Practice address
- 273 Oakpointe Drive
Fort Ashby, WV 26719-1557 - Phone
- (304) 790-2468
- NPI assigned
- Jan 3, 2014
- Last updated
- Aug 23, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 300 | WV | Primary |
Addresses
Primary practice location
273 Oakpointe Drive
Fort Ashby, WV 26719-1557
Mailing address
PO Box 1557
Fort Ashby, WV 26719-1557
Phone (304) 790-2468
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
| License | State | Type | Specialty |
|---|---|---|---|
| 300 | WV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471910400000",
"number": "1124449566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1557",
"city": "FORT ASHBY",
"state": "WV",
"postal_code": "267191557",
"telephone_number": "304-790-2468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "273 OAKPOINTE DRIVE",
"city": "FORT ASHBY",
"state": "WV",
"postal_code": "267191557",
"telephone_number": "304-790-2468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOLLI",
"first_name": "RAYMOND",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-01-03",
"last_updated": "2016-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Ashby, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.