Active NPI
Lisa Marie Lysik, OTR/L
- Occupational Therapist
- Raleigh, NC
National Provider Identifier
1194155218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4469
- Practice address
- 10010 Falls of Neuse Rd Ste 15
Raleigh, NC 27614-8495 - Phone
- (919) 350-1508
- Fax
- (919) 350-1475
- NPI assigned
- Nov 26, 2013
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4469 | NC | Primary |
Addresses
Primary practice location
10010 Falls of Neuse Rd Ste 15
Raleigh, NC 27614-8495
Mailing address
10010 Falls of Neuse Rd Ste 15
Raleigh, NC 27614-8495
Phone (919) 350-1508
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 |
|---|---|---|---|
| 4469 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Specialty Physicians, LLC | Occupational Therapist | 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": "1385424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386201600000",
"number": "1194155218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10010 FALLS OF NEUSE RD STE 15",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276148495",
"telephone_number": "919-350-1508",
"fax_number": "919-350-1475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10010 FALLS OF NEUSE RD STE 15",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276148495",
"telephone_number": "919-350-1508",
"fax_number": "919-350-1475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYSIK",
"first_name": "LISA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-26",
"last_updated": "2013-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "4469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.