Active NPI
Alyssa M Lonergan, DPT
- Physical Therapist
- Saint Paul, MN
National Provider Identifier
1396287769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9046
- Practice address
- 1055 Westgate Dr
Saint Paul, MN 55114-1065 - Phone
- (651) 635-9173
- NPI assigned
- Nov 16, 2016
- Last updated
- Aug 15, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12910-24 | WI | |
| Physical Therapist | 225100000X | 9046 | MN | Primary |
Addresses
Primary practice location
1055 Westgate Dr
Saint Paul, MN 55114-1065
Mailing address
1055 Westgate Dr
Saint Paul, MN 55114-1065
Phone (651) 635-9173
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12910-24 | Other | MN | STATE LICENSE |
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 |
|---|---|---|---|
| 9046 | MN | MD | Physical Therapist |
| 12910-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565827200000",
"number": "1396287769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 WESTGATE DR",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551141065",
"telephone_number": "651-635-9173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 WESTGATE DR",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551141065",
"telephone_number": "651-635-9173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONERGAN",
"first_name": "ALYSSA",
"middle_name": "M",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-16",
"last_updated": "2019-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "12910-24",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "9046",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "12910-24",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.