Individual provider Active NPI

Traci Lopina, MPT,CERT MDT

  • Orthopedic Physical Therapist
  • Shorewood, IL
National Provider Identifier
1366583148
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
070.012932 Issued in IL
Practice address
606 Cambridge LN
Shorewood, IL 60404-0525
Phone
(708) 743-6619
Fax
(815) 744-2646
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 070.012932 IL Primary

Addresses

Primary practice location

606 Cambridge LN
Shorewood, IL 60404-0525

Mailing address

606 Cambridge LN
Shorewood, IL 60404-0525
Phone (708) 743-6619

Other identifiers 1

IdentifierTypeStateIssuer
F300263933OtherILMEDICARE PTAN

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.012932ILMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Physical Therapy & Rehabilitation, LTD Orthopedic PastSince Aug 1, 2005 Accepting new patients
Midwest Rehabilitation Group Inc Orthopedic PastSince Sep 1, 2021 Accepting new patients

Organizations & group practices 2

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1366583148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 CAMBRIDGE LN",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604040525",
            "telephone_number": "708-743-6619",
            "fax_number": "815-744-2646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 CAMBRIDGE LN",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604040525",
            "telephone_number": "708-743-6619",
            "fax_number": "815-744-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPINA",
        "first_name": "TRACI",
        "credential": "MPT,CERT MDT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IL",
            "license": "070.012932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "F300263933",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shorewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; 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.