Light Connection Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1157 Issued in TN

Legal business name

LIGHT CONNECTION INC

Practice address

112 E Myrtle Ave
Ste 312
Johnson City, TN 37601-8600

Phone

(423) 737-1151

NPI assigned

Jan 18, 2012

Organization subpart

No

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

Authorized official

Name

Linda W Brickey

Title

Secretary/Treasurer

Phone

(423) 543-8878

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1548531890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E MYRTLE AVE",
            "address_2": "STE 312",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376018600",
            "telephone_number": "423-737-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E MYRTLE AVE",
            "address_2": "STE 312",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376018600",
            "telephone_number": "423-737-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHT CONNECTION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "BRICKEY",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "423-543-8878"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT1157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarai Nicole Lewis, MSW
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• Kimberly Dawn Lilley, FNP-C
• David R Lilly, PT

• Physical Therapist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.