Active NPI
Lisa J Roehl, DPT
- Pediatric Physical Therapist
- Greenville, SC
National Provider Identifier
1457656365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 6124
- Practice address
- 28 Jimmy Doolittle Dr
Greenville, SC 29607-2622 - Phone
- (864) 679-8606
- Fax
- (864) 679-8608
- NPI assigned
- Jan 24, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 6124 | SC | Primary |
Addresses
Primary practice location
28 Jimmy Doolittle Dr
Greenville, SC 29607-2622
Mailing address
8811 Warren H. Abernathy Hwy.
Spartanburg, SC 29301-1228
Phone (864) 574-7282
Other practice location 1
28 Jimmy Doolittle Dr
Greenville, SC 29607-2622
Phone (864) 595-4225
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 |
|---|---|---|---|
| 6124 | SC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Therapy Solutions, Inc | Past | Accepting new patients | |
| Advanced Therapy Solutions, Inc. | Pediatrics | Past | 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.
-
- Occupational Therapist
- Greenville, SC
- NPI 1528593589
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1457656365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8811 WARREN H. ABERNATHY HWY.",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293011228",
"telephone_number": "864-574-7282",
"fax_number": "864-574-7664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 JIMMY DOOLITTLE DR",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296072622",
"telephone_number": "864-679-8606",
"fax_number": "864-679-8608"
}
],
"practiceLocations": [
{
"address_1": "28 Jimmy Doolittle Dr",
"address_purpose": "LOCATION",
"city": "Greenville",
"state": "SC",
"postal_code": "296072622",
"country_code": "US",
"telephone_number": "864-595-4225",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROEHL",
"first_name": "LISA",
"middle_name": "J",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-24",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "SC",
"license": "6124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.