Lori Ann Linville-Petrik, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4214 Issued in AZ

Practice address

2585 Miracle Mile
Suite 107
Bullhead City, AZ 86442-7522

Phone

(928) 444-8168

Fax

(928) 444-8169

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Kentucky College of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paragon Physical Therapy and Rehab LLCGroup PAC ID 4284902339, 87 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Paragon Physical Therapy and Rehab, LLC

  • Physical Therapy Clinic/Center
  • Bullhead City, AZ
  • NPI 1538694104
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1518065721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 MIRACLE MILE",
            "address_2": "SUITE 107",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427522",
            "telephone_number": "928-444-8168",
            "fax_number": "928-444-8169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2585 MIRACLE MILE",
            "address_2": "SUITE 107",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427522",
            "telephone_number": "928-444-8168",
            "fax_number": "928-444-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINVILLE-PETRIK",
        "first_name": "LORI",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "4214",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1193",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "4214",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "1193",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• May Li
• Geraldine Liban, RN
• Dragana Lim, RPH
• Juanito Y Lim, MD
• Link Medical Inc
• Lion Clinical Services LLC
• Angela Marie Lipinski, FNP-C
• Brielle Lynn Lira, DMD
• Robert L Lock, II, D.O.
• Lesa Renee Lock, APRN

• Physical Therapist in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.