Active NPI
Lisa J Bodor
- Physical Therapist
- Leesport, PA
National Provider Identifier
1356467252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT006907L
- Practice address
- 1011 Berks Rd
Leesport, PA 19533 - Phone
- (610) 376-4841
- NPI assigned
- Mar 22, 2007
- 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 | PT006907L | PA | Primary |
Addresses
Primary practice location
1011 Berks Rd
Leesport, PA 19533
Mailing address
115 Cross Rd
Gilbertsville, PA 19525-9218
Phone (610) 367-6843
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 |
|---|---|---|---|
| PT006907L | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356467252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 CROSS RD",
"city": "GILBERTSVILLE",
"state": "PA",
"postal_code": "195259218",
"telephone_number": "610-367-6843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 BERKS RD",
"city": "LEESPORT",
"state": "PA",
"postal_code": "19533",
"telephone_number": "610-376-4841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODOR",
"first_name": "LISA",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT006907L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leesport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.