Lacey Nordby, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2126630 Issued in TX

Practice address

15614 Huebner Rd
Suite 115
San Antonio, TX 78248-0992

Phone

(210) 647-9970

Fax

(610) 647-7229

NPI assigned

Mar 9, 2017

Last updated

Mar 9, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Promotion Physical Therapy, P.C.

  • Physical Therapist
  • San Antonio, TX
  • NPI 1689665945
  NPD (past)

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1326589425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15614 HUEBNER RD",
            "address_2": "SUITE 115",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782480992",
            "telephone_number": "210-647-9970",
            "fax_number": "610-647-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15614 HUEBNER RD",
            "address_2": "SUITE 115",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782480992",
            "telephone_number": "210-647-9970",
            "fax_number": "610-647-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDBY",
        "first_name": "LACEY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-09",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2126630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF PHYSICAL THERAPY EXAMINERS",
            "identifier": "2126630",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Negin Nooshin, OD
• Nora I Valdes MD PA
• Nora Lee Walker MD PA
• Kristi Rae Norcross, CNM
• Norcubi PLLC
• Nordstrom Inc & Subsidiaries
• Michael John Norgard, M.D.
• Noriega Dental Group PLLC
• Corinna Noriega, LVN
• Gabriella Noriega

• Physical Therapy Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; 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.