Lisa Marie Flores, P.T.A

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA.0012393 Issued in CO

Practice address

12105 Ambassador Drive
Liberty Heights (Paragon Rehab)
Colorado Springs, CO 80921

Phone

(719) 493-9667

NPI assigned

Feb 17, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Lisa Marie Brackman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1306980834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12105 AMBASSADOR DRIVE",
            "address_2": "LIBERTY HEIGHTS (PARAGON REHAB)",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80921",
            "telephone_number": "719-439-9667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12105 AMBASSADOR DRIVE",
            "address_2": "LIBERTY HEIGHTS (PARAGON REHAB)",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80921",
            "telephone_number": "719-493-9667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E State St",
            "address_2": "Genesis Rehab Services",
            "address_purpose": "LOCATION",
            "city": "Kennett Square",
            "state": "PA",
            "postal_code": "193483109",
            "country_code": "US",
            "telephone_number": "800-367-5690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLORES",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "P.T.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-17",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P1 60415386",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2059028",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "PTA.0012393",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ID",
            "license": "PTA-3689",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "BRACKMAN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Breana Flores
• Cecilia Flores, CSFA
• Elizabeth Anne Flores
• Erin Flores
• Lisa Marie Flores
• Vanessa Flores, RBT
• Beatrice Dolores Florez, LCSW
• Hannah Flory, MD
• Anna Flosky
• Flourish Dental and Wellness

• Physical Therapy Assistant in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Physical Therapy Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; 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.