Individual provider Active NPI

Lisa Podlecki, PT

  • Physical Therapist
  • Summersville, WV
National Provider Identifier
1215419874
Registry record updated Oct 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
004303 Issued in WV
Practice address
207 Merchants Walk
Summersville, WV 26651-1901
Phone
(048) 727-4983
NPI assigned
Aug 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 004303 WV Primary

Addresses

Primary practice location

207 Merchants Walk
Summersville, WV 26651-1901

Mailing address

PO Box 494
Mount Lookout, WV 26678-0494
Phone (303) 903-7061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.3 of 100Reported as group
Quality
71.18
Promoting interoperability
92
Improvement activities
40
Cost
79.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004303WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Greenbrier Valley Physical Therapy, LLC Physical Therapist CurrentSince Nov 7, 2022 Accepting new patients
Greenbrier Valley Physical Therapy LLC CurrentSince Nov 7, 2022 Accepting new patients
Mountaineer Physical Therapy & Sports Medicine Physical Therapist CurrentSince Oct 22, 2020 Accepting new patients
Greenbrier Valley Physical Therapy, LLC Physical Therapist Current Accepting new patients
Warren Physical Therapy PLLC Physical Therapist PastSince May 4, 2025 Accepting new patients
Greenbrier Valley Physical Therapy, LLC Past Accepting new patients

Locations

436 Central Ave
Oak Hill, WV 25901
Phone (304) 465-3654

3942 Davis Stuart Rd
Ste 3
Ronceverte, WV 24970
Phone (304) 647-3987

207 Merchants Walk
Summersville, WV 26651
Phone (304) 872-7498

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601683200000",
    "number": "1215419874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 494",
            "city": "MOUNT LOOKOUT",
            "state": "WV",
            "postal_code": "266780494",
            "telephone_number": "303-903-7061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 MERCHANTS WALK",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266511901",
            "telephone_number": "048-727-4983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODLECKI",
        "first_name": "LISA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2020-10-03",
        "certification_date": "2020-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "004303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summersville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.