Active NPI
Lisa M Davis, PT
- Physical Therapist
- West Hartford, CT
National Provider Identifier
1598329948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4461
- Practice address
- 29 Highland St
West Hartford, CT 06119-1324 - Phone
- (860) 236-5623
- NPI assigned
- Apr 30, 2019
- Last updated
- Apr 30, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4461 | CT | Primary |
Addresses
Primary practice location
29 Highland St
West Hartford, CT 06119-1324
Mailing address
1073 Peck LN
Cheshire, CT 06410-1530
Phone (203) 980-0278
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4461 | CT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556582400000",
"number": "1598329948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1073 PECK LN",
"city": "CHESHIRE",
"state": "CT",
"postal_code": "064101530",
"telephone_number": "203-980-0278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 HIGHLAND ST",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061191324",
"telephone_number": "860-236-5623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "LISA",
"middle_name": "M",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-30",
"last_updated": "2019-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "4461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.