Individual provider Active NPI

Lisa Jerry, PT, DPT

  • Physical Therapist
  • Glassboro, NJ
National Provider Identifier
1558956243
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP044993T Issued in NJ
Practice address
707 N Main St
Glassboro, NJ 08028-1605
Phone
(856) 307-9700
NPI assigned
Mar 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305214146 VA
Physical Therapist 225100000X PT872756 DC
Physical Therapist 225100000X CP044993T NJ Primary

Addresses

Primary practice location

707 N Main St
Glassboro, NJ 08028-1605

Mailing address

707 N Main St Ste 1
Glassboro, NJ 08028-1670

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250710002667 NJ Practitioner - Physical Therapist in Private Practice 2163839648 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP044993TNJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabclinics SPT, Inc. CurrentSince Jul 14, 2025 Accepting new patients
Rehabclinics SPT Inc CurrentSince Jul 14, 2025 Accepting new patients
Osprey Rehabilitation, LLC. Physical Therapist CurrentSince Jul 14, 2025 Accepting new patients
Rehabclinics SPT Inc. Current Accepting new patients
Osprey Rehabilitation, LLC. CurrentSince Jul 14, 2025 Accepting new patients
Rehabclinics SPT Inc Past Accepting new patients

Locations

2144 US Highway 130
Ste 12
Bordentown, NJ 08505
Phone (609) 324-9320

707 N Main St
Glassboro, NJ 08028
Phone (856) 307-9700

707 N Main St
Ste 1
Glassboro, NJ 08028
Phone (856) 307-9700

240 S White Horse Pike
Ste C6
Hammonton, NJ 08037
Phone (609) 561-5308

127 Bridgeton Pike
Unit D
Mullica Hill, NJ 08062
Phone (856) 478-0275

Organizations & group practices 6

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": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1558956243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 N MAIN ST STE 1",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080281670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N MAIN ST",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080281605",
            "telephone_number": "856-307-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERRY",
        "first_name": "LISA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-04",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305214146",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "PT872756",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "CP044993T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glassboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.