Active NPI
Lauren Elizabeth Perisa-Cicchillo, PT, DPT
- Physical Therapist
- Warren, OH
National Provider Identifier
1760891428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT014947
- Practice address
- 1553 Niles Cortland Rd SE Ste 1
Warren, OH 44484-3073 - Phone
- (330) 372-2324
- Fax
- (330) 372-2309
- NPI assigned
- Aug 7, 2014
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | |||
| Neurology Physical Therapist | 2251N0400X | |||
| Hand Physical Therapist | 2251H1200X | |||
| Sports Physical Therapist | 2251S0007X | |||
| Physical Therapist | 225100000X | PT014947 | OH | Primary |
Addresses
Primary practice location
1553 Niles Cortland Rd SE Ste 1
Warren, OH 44484-3073
Mailing address
1553 Niles Cortland Rd SE Ste 1
Warren, OH 44484-3073
Phone (330) 372-2324
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0109240 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT014947 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449532800000",
"number": "1760891428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1553 NILES CORTLAND RD SE STE 1",
"city": "WARREN",
"state": "OH",
"postal_code": "444843073",
"telephone_number": "330-372-2324",
"fax_number": "330-372-2309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1553 NILES CORTLAND RD SE STE 1",
"city": "WARREN",
"state": "OH",
"postal_code": "444843073",
"telephone_number": "330-372-2324",
"fax_number": "330-372-2309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERISA-CICCHILLO",
"first_name": "LAUREN",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-07",
"last_updated": "2015-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": null,
"license": null,
"primary": false
},
{
"code": "2251N0400X",
"taxonomy_group": "",
"desc": "Physical Therapist, Neurology",
"state": null,
"license": null,
"primary": false
},
{
"code": "2251H1200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Hand",
"state": null,
"license": null,
"primary": false
},
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT014947",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0109240",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warren, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.