Active NPI
Matthew Lisk, ATC, DPT
- Physical Therapist
- Clayton, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P13758
- Practice address
- 166 Springbrook Ave Ste 201
Clayton, NC 27520-8520 - Phone
- (828) 492-0592
- Fax
- (410) 648-4878
- NPI assigned
- Jul 9, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | P13758 | NC | Primary |
Addresses
Primary practice location
166 Springbrook Ave Ste 201
Clayton, NC 27520-8520
Mailing address
350 New Fidelity CT
Garner, NC 27529-2665
Phone (919) 258-2714
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Brody School of Medicine at East Carolina University, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1417 S Pollock St
Selma, NC 27576-3405
Phone (919) 300-5040
166 Springbrook Ave
Suite 201
Clayton, NC 27520-8520
Phone (919) 535-8461
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.67 of 100
- Quality
- 85.21
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 77.85
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13758 | NC | MD | Dentist |
| P13758 | NC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Activcare Physical Therapy, LLC | Physical Therapist | Current | Accepting new patients |
Locations
1801 Olive Chapel Rd
Ste 103
Apex, NC 27502
Phone (919) 373-5353
166 Springbrook Ave
Ste 201
Clayton, NC 27520
Phone (919) 535-8461
350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919
3410 Executive Dr
Ste 205
Raleigh, NC 27609
Phone (919) 322-0042
3200 Blue Ridge Rd
Ste 122
Raleigh, NC 27612
Phone (919) 781-0018
Interoperability endpoints
- matthew.lisk.p12@direct.athleticoltd.nextgenshare.com
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641168000000",
"number": "1730444522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 NEW FIDELITY CT",
"city": "GARNER",
"state": "NC",
"postal_code": "275292665",
"telephone_number": "919-258-2714",
"fax_number": "410-648-4878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "166 SPRINGBROOK AVE STE 201",
"city": "CLAYTON",
"state": "NC",
"postal_code": "275208520",
"telephone_number": "828-492-0592",
"fax_number": "410-648-4878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LISK",
"first_name": "MATTHEW",
"credential": "ATC, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-09",
"last_updated": "2022-01-03",
"certification_date": "2022-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P13758",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clayton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.