Luanne Maria Macisaac, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT013826 Issued in GA

Practice address

7130 Mount Zion Blvd Ste 9
Jonesboro, GA 30236-2566

Phone

(770) 603-5660

Fax

(770) 603-6779

NPI assigned

Aug 30, 2006

Last updated

Oct 21, 2019By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1700996642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214915",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7130 MOUNT ZION BLVD STE 9",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362566",
            "telephone_number": "770-603-5660",
            "fax_number": "770-603-6779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1555 Saxon Blvd",
            "address_2": "ste 101",
            "address_purpose": "LOCATION",
            "city": "Deltona",
            "state": "FL",
            "postal_code": "327255861",
            "country_code": "US",
            "telephone_number": "386-574-5247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACISAAC",
        "first_name": "LUANNE",
        "middle_name": "MARIA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT013826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE#",
            "identifier": "PT5430",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vadim Lvovich
• Tania Lynch, RN
• M & S Exams on the Go
• M&a Home Care, LLC
• M&M Surgical Associates
• Felicia M Mack, PCA
• Emily Jo Anderson Mackillop, PH.D.
• Brooks Wells Maddox III, DMD
• Abelardo B Magat, MD
• Dewayne Alvin Magee Sr.

• Physical Therapist in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.