Active NPI
Lisa K Gross, DPT
- Physical Therapist
- Bellevue, NE
National Provider Identifier
1821271560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2621
- Practice address
- 2909 Daniell Cir
Bellevue, NE 68123-1980 - Phone
- (123) 456-7890
- NPI assigned
- Dec 17, 2007
- Sex
- Female
- 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 | 2621 | NE | Primary |
Addresses
Primary practice location
2909 Daniell Cir
Bellevue, NE 68123-1980
Mailing address
2909 Daniell Cir
Bellevue, NE 68123-1980
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02460 | Other | NE | BCBS NEBRASKA |
| P00609476 | Other | NE | RR MEDICARE |
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 |
|---|---|---|---|
| 2621 | NE | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284940800000",
"number": "1821271560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2909 DANIELL CIR",
"city": "BELLEVUE",
"state": "NE",
"postal_code": "681231980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2909 DANIELL CIR",
"city": "BELLEVUE",
"state": "NE",
"postal_code": "681231980",
"telephone_number": "123-456-7890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSS",
"first_name": "LISA",
"middle_name": "K",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-17",
"last_updated": "2010-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "2621",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NEBRASKA",
"identifier": "02460",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00609476",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.