Active NPI
Lisa Alexandra Patrick, D.C.
- Chiropractor
- Boiling Springs, SC
National Provider Identifier
1629448766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4059
- Practice address
- 286 Giles Drive
Boiling Springs, SC 29316-6036 - Phone
- (989) 200-1158
- NPI assigned
- Oct 1, 2015
- Last updated
- Nov 23, 2021
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4059 | SC | Primary |
Addresses
Primary practice location
286 Giles Drive
Boiling Springs, SC 29316-6036
Mailing address
286 Giles Drive
Boiling Springs, SC 29316
Phone (989) 200-1158
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4059 | SC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637625600000",
"number": "1629448766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "286 GILES DRIVE",
"city": "BOILING SPRINGS",
"state": "SC",
"postal_code": "29316",
"telephone_number": "989-200-1158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "286 GILES DRIVE",
"city": "BOILING SPRINGS",
"state": "SC",
"postal_code": "293166036",
"telephone_number": "989-200-1158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATRICK",
"first_name": "LISA",
"middle_name": "ALEXANDRA",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-01",
"last_updated": "2021-11-23",
"certification_date": "2021-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "SC",
"license": "4059",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boiling Springs, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.