Lisa Christine Petrie, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501003800 Issued in MI

Practice address

1622 Dickerson Rd
Gaylord, MI 49735-9206

Phone

(989) 731-1777

Fax

(989) 731-1166

NPI assigned

Sep 13, 2010

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

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northsport Physical Therapy and Rehabilitation P CGroup PAC ID 5294902508, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Northsport Physical Therapy & Rehabilitation PC

  • Physical Therapist
  • Fairview, MI
  • NPI 1003253170
  Medicare reassignment Care Compare group NPD Authorized official
• Mymichigan Medical Center Midland

  • Anesthesiology Physician
  • Midland, MI
  • NPI 1649010455
  NPD (past)
• Northsport Physical Therapy & Rehabilitation P C

  • Physical Therapist
  • Gaylord, MI
  • NPI 1942387733
  NPD (past)

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1699082545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 DICKERSON RD",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497359206",
            "telephone_number": "989-731-1777",
            "fax_number": "989-731-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 DICKERSON RD",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497359206",
            "telephone_number": "989-731-1777",
            "fax_number": "989-731-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRIE",
        "first_name": "LISA",
        "middle_name": "CHRISTINE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-13",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501003800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Maree Perry, BEHAVIOR TECHNICIAN
• Julia Alexandra-Saldana Perry, LPC
• Suzan Petee
• Hannah Leigh Peters
• Mikhayla Rose Peters
• Jennifer Kristen Pewinski, LLPC
• Pierce Eye Care LLC
• Pine Trees Medical Office, P.C.
• Prac Holdings, Inc.
• Sydney Kadence Prange

• Physical Therapist in Gaylord, MI
• Providers in Gaylord, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.