Individual provider Active NPI

Lisa A McCourt, PTA

  • Physical Therapy Assistant
  • Wintersville, OH
National Provider Identifier
1245461003
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
01664 Issued in OH
Practice address
135 Reichart Ave
Wintersville, OH 43953-4050
Phone
(740) 266-6940
Fax
(740) 266-6942
NPI assigned
Jul 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 01664 OH Primary

Addresses

Primary practice location

135 Reichart Ave
Wintersville, OH 43953-4050

Mailing address

135 Reichart Ave
Wintersville, OH 43953-4050
Phone (740) 266-6940

Other identifiers 1

IdentifierTypeStateIssuer
01664OtherOHOHIO STATE 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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
01664OHMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248739200000",
    "number": "1245461003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 REICHART AVE",
            "city": "WINTERSVILLE",
            "state": "OH",
            "postal_code": "439534050",
            "telephone_number": "740-266-6940",
            "fax_number": "740-266-6942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 REICHART AVE",
            "city": "WINTERSVILLE",
            "state": "OH",
            "postal_code": "439534050",
            "telephone_number": "740-266-6940",
            "fax_number": "740-266-6942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOURT",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2009-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "01664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO STATE LICENSE",
            "identifier": "01664",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wintersville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; 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.