Lisa Anderson, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

26921 Issued in FL

Practice address

4101 Southpoint Dr E
Jacksonville, FL 32216-0996

Phone

(904) 296-6800

NPI assigned

Mar 23, 2007

Last updated

Aug 17, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Move Mobile Therapy LLCGroup PAC ID 0446681605, 2 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Move Mobile Therapy LLC

  • Physical Therapy Clinic/Center
  • Ponte Vedra, FL
  • NPI 1649817206
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1821115288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 CROSSTIDE CIR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320824028",
            "telephone_number": "508-208-1322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 SOUTHPOINT DR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322160996",
            "telephone_number": "904-296-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "LISA",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "8630",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "26921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim G Anderson, LMT
• Kristi Marie Anderson, DO
• Kristin Kelly Anderson, M.D.
• Lindsey Anderson
• Lindsey Anderson
• Melody Anderson
• Michael Lee Anderson, APRN
• Michelle Anderson, MS, LMHC
• Nicole Sunderland Anderson, MD
• Payton Elizabeth Anderson

• Physical Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; 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.