Active NPI
Lisa Tankersley
- Physical Therapist
- Welch, WV
National Provider Identifier
1649427220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 001016
- Practice address
- 30 Central Ave
Welch, WV 24801-2008 - Phone
- (304) 436-8441
- NPI assigned
- Aug 26, 2008
- Last updated
- Aug 26, 2008
- 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 | 001016 | WV | Primary |
Addresses
Primary practice location
30 Central Ave
Welch, WV 24801-2008
Mailing address
30 Central Ave
Welch, WV 24801-2008
Phone (304) 436-8441
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7305053000 | Medicaid | WV |
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 |
|---|---|---|---|
| 001016 | WV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219708800000",
"number": "1649427220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 CENTRAL AVE",
"city": "WELCH",
"state": "WV",
"postal_code": "248012008",
"telephone_number": "304-436-8441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 CENTRAL AVE",
"city": "WELCH",
"state": "WV",
"postal_code": "248012008",
"telephone_number": "304-436-8441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANKERSLEY",
"first_name": "LISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-26",
"last_updated": "2008-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "001016",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7305053000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Welch, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.