Lisa Wisniewski, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT17117 Issued in FL

Practice address

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167

Phone

(386) 231-6039

NPI assigned

Mar 16, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1659907244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 BUFFALO GROVE PL",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321379462",
            "telephone_number": "386-864-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MEMORIAL MEDICAL PKWY",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175167",
            "telephone_number": "386-231-6039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-16",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT17117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Scott Winecoff, APRN
• Shandrea Wing
• Andrew Winquist, RD
• Amber Nicole Wise, PT, DPT
• Judith Kay Wisher, MA, LMHC
• Maria Christine Witherspoon, MD
• Mary Teresa Wittnebert, DNP, ARNP, FNP-BC
• Karina Wold, PHARMD
• Hanna Woldeyes
• Amy Lynn Wolf, D.C.

• Physical Therapist in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; 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.