Individual provider Active NPI

Lisa Jane Avery, PT

  • Physical Therapist
  • Raleigh, NC
National Provider Identifier
1477866515
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8428 Issued in NC
Practice address
5920 Sandy Forks Rd Ste 200
Raleigh, NC 27609-3814
Phone
(919) 954-3492
NPI assigned
Jul 19, 2010
Last updated
May 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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 8428 NC Primary

Addresses

Primary practice location

5920 Sandy Forks Rd Ste 200
Raleigh, NC 27609-3814

Mailing address

5920 Sandy Forks Rd Ste 200
Raleigh, NC 27609-3814
Phone (919) 954-3492

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121107000430 NC Practitioner - Physical Therapist in Private Practice 5193976777 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Health System, Inc. CurrentSince Jan 9, 2019 Accepting new patients
Duke University Health System, Inc. Physical Therapist CurrentSince Jan 9, 2019 Accepting new patients
Access Physical Therapy, LLC Physical Therapist Past Accepting new patients
Access Physical Therapy & Wellness, Inc Physical Therapist Past Accepting new patients

Locations

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

3609 Southwest Durham Dr
Durham, NC 27707
Phone (919) 403-5180

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

3325 Executive Dr
Ste 222
Raleigh, NC 27609
Phone (919) 954-3492

5920 Sandy Forks Rd
Ste 200
Raleigh, NC 27609
Phone (919) 954-3174

Organizations & group practices 4

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": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1477866515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 SANDY FORKS RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276093814",
            "telephone_number": "919-954-3492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 SANDY FORKS RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276093814",
            "telephone_number": "919-954-3492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERY",
        "first_name": "LISA",
        "middle_name": "JANE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-19",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "8428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.