Individual provider Active NPI

Lisa Robyn O'Connor, P.T.

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Mountain View, CA
National Provider Identifier
1245367358
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
License
PT33223 Issued in CA
Practice address
1235 Pear Ave
# 101
Mountain View, CA 94043-1444
Phone
(650) 965-8434
Fax
(650) 965-8545
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X PT33223 CA Primary

Addresses

Primary practice location

1235 Pear Ave
# 101
Mountain View, CA 94043-1444

Mailing address

PO Box 8125
Fountain Valley, CA 92728-8125
Phone (650) 965-8434

Other identifiers 1

IdentifierTypeStateIssuer
PT33223OtherCASTATE LICENSE

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

LicenseStateTypeSpecialty
PT33223CAMDSports Medicine (Neuromusculoskeletal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Creek Fitness and Physical Therapy PastSince Oct 26, 2010 Accepting new patients
Restor Physical Therapy Past Accepting new patients

Organizations & group practices 2

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1245367358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8125",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927288125",
            "telephone_number": "650-965-8434",
            "fax_number": "650-965-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 PEAR AVE",
            "address_2": "# 101",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940431444",
            "telephone_number": "650-965-8434",
            "fax_number": "650-965-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "LISA",
        "middle_name": "ROBYN",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "CA",
            "license": "PT33223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PT33223",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.

Verify at the official NPI Registry.