Lisa Willard, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070017030 Issued in IL

Practice address

10 Doctors Park
Gibson City, IL 60936-2004

Phone

(217) 784-2650

NPI assigned

Aug 12, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa Doman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gibson Area Hospital Therapy Services

  • Rural Acute Care Hospital
  • Gibson City, IL
  • NPI 1154679108
  Authorized official Same address or phone
• Gibson Community Hospital Association

  dba Cissna Park Therapy

  • Physical Therapy Clinic/Center
  • Cissna Park, IL
  • NPI 1295343374

  Physical Therapist

  NPD
• Gibson Community Hospital Association

  dba Family Healthcare of Gibson City

  • Family Medicine Physician
  • Gibson City, IL
  • NPI 1699922138
  NPD (past)

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1134894017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 N MELVIN ST",
            "city": "GIBSON CITY",
            "state": "IL",
            "postal_code": "609361477",
            "telephone_number": "217-784-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DOCTORS PARK",
            "city": "GIBSON CITY",
            "state": "IL",
            "postal_code": "609362004",
            "telephone_number": "217-784-2650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 Prairie Ln Unit C",
            "address_purpose": "LOCATION",
            "city": "Cissna Park",
            "state": "IL",
            "postal_code": "609249704",
            "country_code": "US",
            "telephone_number": "815-457-2006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "LISA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070017030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "DOMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tammy Walker, COTA/L
• Natalie Weaver, PMHNP
• Ingrid I Wheeler
• Lauren Whitecotton, BA
• Rebecca Anne Wildermuth, MS ATC CSCS
• Williams Chiropractic LTD
• Adrianna Lin Williams, DNP FNP-BC
• Carol Calhoun Williams, M.D.
• Daniel Earl Williams, DC

• Physical Therapist in Gibson City, IL
• Providers in Gibson City, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.