Active NPI
Lisa Ann Mortensen, M.P.T.
- Physical Therapist
- Boerne, TX
National Provider Identifier
1295039345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1192920
- Practice address
- 26314 Presidio BLF
Boerne, TX 78015-6560 - Phone
- (210) 954-2806
- NPI assigned
- Jan 4, 2011
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1192920 | TX | Primary |
Addresses
Primary practice location
26314 Presidio BLF
Boerne, TX 78015-6560
Mailing address
26314 Presidio BLF
Boerne, TX 78015-6560
Phone (210) 954-2806
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 |
|---|---|---|---|
| 1192920 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Layton Hills Chiropractic | 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.
-
- Chiropractor
- Layton, UT
- NPI 1447305198
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294099200000",
"number": "1295039345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26314 PRESIDIO BLF",
"city": "BOERNE",
"state": "TX",
"postal_code": "780156560",
"telephone_number": "210-954-2806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26314 PRESIDIO BLF",
"city": "BOERNE",
"state": "TX",
"postal_code": "780156560",
"telephone_number": "210-954-2806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORTENSEN",
"first_name": "LISA",
"middle_name": "ANN",
"credential": "M.P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-04",
"last_updated": "2011-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1192920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boerne, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.