Individual provider Active NPI

Lisa V Alexander, PT

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1457787574
Registry record updated Sep 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT011193 Issued in GA
Practice address
2221 Peachtree Rd NE
Suite D336
Atlanta, GA 30309-1148
Phone
(404) 846-0886
NPI assigned
Sep 20, 2013
Last updated
Sep 20, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT011193 GA Primary

Addresses

Primary practice location

2221 Peachtree Rd NE
Suite D336
Atlanta, GA 30309-1148

Mailing address

898 Dean Dr NW
Atlanta, GA 30318-1616
Phone (404) 808-1328

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
PT011193GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Life Clinic of Ga PC Physical Therapist PastSince Dec 3, 2022 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1457787574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "898 DEAN DR NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303181616",
            "telephone_number": "404-808-1328",
            "fax_number": "404-846-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 PEACHTREE RD NE",
            "address_2": "SUITE D336",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091148",
            "telephone_number": "404-846-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "LISA",
        "middle_name": "V",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-20",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.