Lisa Renee Koperna, PT, DPT, SCS, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305004592 Issued in VA

Practice address

1015 W 47TH St
Norfolk, VA 23529-0001

Phone

(757) 683-4228

Fax

(757) 683-7050

NPI assigned

Mar 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Lisa Renee Jesberg Other name

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Old Dominion UniversityGroup PAC ID 3476770520, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Old Dominion University

  • Physical Therapist
  • Norfolk, VA
  • NPI 1871929729
  Medicare reassignment Care Compare group NPD Authorized official
• Vann-Virginia Center for Orthopaedics PC

  • Orthopaedic Surgery Physician
  • Virginia Beach, VA
  • NPI 1184666877

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1720057110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 W 47TH ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235290001",
            "telephone_number": "757-683-4228",
            "fax_number": "757-683-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 W 47TH ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235290001",
            "telephone_number": "757-683-4228",
            "fax_number": "757-683-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPERNA",
        "first_name": "LISA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, SCS, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305004592",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "VA",
            "license": "2305004592",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126000619",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "JESBERG",
            "middle_name": "RENEE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Konikoff Family Dentistry
• Michael R. Konikoff, M.D.
• Stephen E Konikoff, DDS
• Konnect Kare Home Health Agency
• Sarah Kooiman, LMFT
• David Jeffrey Kosek, DMD PHD
• Sarah Kimberly Kosinski, GNP-BC
• Lauren Elizabeth Kovacs, SLP
• Iuliia Kovalenko, M.D.
• Ann Catherine Kownack, C.N.M

• Physical Therapist in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.