Lisa Anne Jacunski, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PA2932 Issued in ME

Practice address

23 Cedar Ridge Dr
Skowhegan, ME 04976-4160

Phone

(207) 474-9686

NPI assigned

Mar 20, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497870182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 OAK HILL DR",
            "city": "OAKLAND",
            "state": "ME",
            "postal_code": "049635004",
            "telephone_number": "207-465-9681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 CEDAR RIDGE DR",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049764160",
            "telephone_number": "207-474-9686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACUNSKI",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ME",
            "license": "PA2932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Ifune, M.D.
• Insight-Premier Health LLC
• Harry Irving, DO
• Randa Jaber, MD
• Jacqueline Tjon Sieuw Morin
• Diana L Jeannotte, M.D.
• Kayla Florence Johnson, LCPC-C
• Judy Byler
• Cathal Kavanagh, DO
• Kathleen R Kavanaugh, RN

• Physical Therapy Assistant in Skowhegan, ME
• Providers in Skowhegan, ME by specialty
• Physical Therapy Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.