Active NPI
Lisa Ann Lepore, D.C.
- Chiropractor
- Port Jefferson Station, NY
National Provider Identifier
1194934042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X006301-1
- Practice address
- 18 Andover Dr
Port Jefferson Station, NY 11776-3014 - Phone
- (631) 474-1743
- Fax
- (631) 474-1770
- NPI assigned
- May 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X006301-1 | NY | Primary |
Addresses
Primary practice location
18 Andover Dr
Port Jefferson Station, NY 11776-3014
Mailing address
18 Andover Dr
Port Jefferson Station, NY 11776-3014
Phone (631) 473-5540
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 |
|---|---|---|---|
| X006301-1 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1194934042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 ANDOVER DR",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117763014",
"telephone_number": "631-473-5540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 ANDOVER DR",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117763014",
"telephone_number": "631-474-1743",
"fax_number": "631-474-1770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEPORE",
"first_name": "LISA",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X006301-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson Station, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.