Individual provider Active NPI

Liselotte Smith-Andersen, PT

  • Physical Therapist
  • Roanoke, VA
National Provider Identifier
1467897397
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305005537 Issued in VA
Practice address
1015 1St St SW Ste 2
Roanoke, VA 24016-4427
Phone
(540) 985-0500
Fax
(540) 985-0529
NPI assigned
May 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 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 2305005537 VA Primary

Addresses

Primary practice location

1015 1St St SW Ste 2
Roanoke, VA 24016-4427

Mailing address

1015 1St St SW Ste 2
Roanoke, VA 24016-4427
Phone (540) 980-5000

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
2305005537VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Back to Basics Family Physical Therapy PC Physical Therapist CurrentSince May 1, 2013 Accepting new patients
Universal Health Corporation PastSince Mar 24, 2017 Accepting new patients

Locations

7768 Williamson Rd
Roanoke, VA 24019
Phone (540) 985-0500

1015 1st St SW
Ste 2
Roanoke, VA 24016
Phone (540) 985-0500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16094/brand/1/csg/1/fhir/r4

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": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367798400000",
    "number": "1467897397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 1ST ST SW STE 2",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164427",
            "telephone_number": "540-980-5000",
            "fax_number": "540-985-0529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 1ST ST SW STE 2",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164427",
            "telephone_number": "540-985-0500",
            "fax_number": "540-985-0529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-ANDERSEN",
        "first_name": "LISELOTTE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-06",
        "last_updated": "2013-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305005537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.