Active NPI
Lisa George, PT
- Pediatric Physical Therapist
- Ward, AR
National Provider Identifier
1700810355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- PT1587
- Practice address
- 1500 Wilson Loop
Ward, AR 72176 - Phone
- (501) 941-5630
- NPI assigned
- Jul 10, 2006
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | PT1587 | AR | Primary |
Addresses
Primary practice location
1500 Wilson Loop
Ward, AR 72176
Mailing address
PO Box 333
Ward, AR 72176-0333
Phone (501) 941-5630
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5U632 | Other | AR | BLUE CROSS BLUE SHIELD |
| 128140721 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210712002761 | AR | Practitioner - Physical Therapist in Private Practice | 1355743410 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allied Therapy and Consulting Services, PA | Current | Accepting new patients | |
| Therakids, LLC | Past | Accepting new patients | |
| Beyond Boundaries, Inc | Past | Accepting new patients |
Locations
5532 John F Kennedy Blvd
North Little Rock, AR 72116
Phone (501) 588-3211
Organizations & group practices 3
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.
-
- Physical Therapist
- Ward, AR
- NPI 1134355043
-
- Early Intervention Provider Agency
- Heber Springs, AR
- NPI 1689006686
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580688000000",
"number": "1700810355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 333",
"city": "WARD",
"state": "AR",
"postal_code": "721760333",
"telephone_number": "501-941-5630",
"fax_number": "501-259-3511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 WILSON LOOP",
"city": "WARD",
"state": "AR",
"postal_code": "72176",
"telephone_number": "501-941-5630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEORGE",
"first_name": "LISA",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-10",
"last_updated": "2020-02-03",
"certification_date": "2020-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "AR",
"license": "PT1587",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "5U632",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "128140721",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ward, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.