Active NPI
Kristie Lacivita
- Physical Therapist
- Warren, OH
National Provider Identifier
1184041071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 014391
- Practice address
- 8323 E Market St
Warren, OH 44484-2342 - Phone
- (330) 651-6824
- NPI assigned
- Mar 28, 2014
- Sex
- Female
- 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 | 014391 | OH | Primary |
Addresses
Primary practice location
8323 E Market St
Warren, OH 44484-2342
Mailing address
7760 E Liberty St
Hubbard, OH 44425-9726
Phone (330) 559-8787
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014391 | Other | OH | PT LICENSE NUMBER |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014391 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395964800000",
"number": "1184041071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7760 E LIBERTY ST",
"city": "HUBBARD",
"state": "OH",
"postal_code": "444259726",
"telephone_number": "330-559-8787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8323 E MARKET ST",
"city": "WARREN",
"state": "OH",
"postal_code": "444842342",
"telephone_number": "330-651-6824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACIVITA",
"first_name": "KRISTIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-28",
"last_updated": "2014-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "014391",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE NUMBER",
"identifier": "014391",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warren, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.