Individual provider Active NPI

Robert G Lisson, O.T.

  • Occupational Therapist
  • Tallahassee, FL
National Provider Identifier
1346635547
Registry record updated Apr 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT8395 Issued in FL
Practice address
1910 Buford Blvd
Tallahassee, FL 32308-4667
Phone
(850) 459-7126
Fax
(850) 597-7062
NPI assigned
Apr 3, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT8395 FL Primary

Addresses

Primary practice location

1910 Buford Blvd
Tallahassee, FL 32308-4667

Mailing address

7877 Maclean Rd
Tallahassee, FL 32312-9052
Phone (850) 459-7126

Other identifiers 1

IdentifierTypeStateIssuer
OT8395OtherFLLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191211002677 FL Practitioner - Occupational Therapist in Private Practice 3971936592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Next PT Group Florida, LLCGroup PAC ID 3173865607, 43 clinicians

Practice addresses (Care Compare)

1060 Clarity Pointe Dr
Tallahassee, FL 32308-6022
Phone (775) 367-6937

12110 Morris Bridge Rd
Temple Terrace, FL 33637-1924
Phone (850) 380-4657

208 E Tharpe St
Tallahassee, FL 32303-5551
Phone (775) 367-6937

2507 Old Saint Augustine Rd
Tallahassee, FL 32301-6209
Phone (775) 367-6937

2601 Crestline Rd
Tallahassee, FL 32308-5995
Phone (850) 380-4657

3255 Vanderbilt Beach Rd
Naples, FL 34109-3400
Phone (850) 380-4657

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Next PT Group Florida, LLC Occupational Therapist CurrentSince Nov 1, 2019 Accepting new patients

Locations

1516 Highway 138
Ste 1C
Wall, NJ 07719

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.

NPI Registry JSON

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428019200000",
    "number": "1346635547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7877 MACLEAN RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323129052",
            "telephone_number": "850-459-7126",
            "fax_number": "850-597-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 BUFORD BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084667",
            "telephone_number": "850-459-7126",
            "fax_number": "850-597-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISSON",
        "first_name": "ROBERT",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-03",
        "last_updated": "2015-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT8395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "OT8395",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.