Lisa Marie Black, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2145210 Issued in TX

Practice address

3433 Cranston Cir
Highlands Ranch, CO 80126-3620

Phone

(720) 431-6442

NPI assigned

Aug 16, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1345075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1326396706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 CRANSTON CIR",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801263620",
            "telephone_number": "720-431-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3433 CRANSTON CIR",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801263620",
            "telephone_number": "720-431-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-16",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "0012904",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2145210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sameer Bisarya, M.D.
• Jessica L Bishop, MD
• Lilly Bithell, MOTR/L
• Kathryn Bixler
• BKD Highlands Ranch, LLC
• Jerry Joe Blanchard
• Lauren Blanchard, M.A., LPC
• Daniel Blankenburg, DMD
• Mary Frances Blatter, OTD
• Bliss Dental Health, LLC

• Physical Therapy Assistant in Highlands Ranch, CO
• Providers in Highlands Ranch, 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 Oct 30, 2020; 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.