Individual provider Active NPI

Lisa Kimberly Ennis, PT MPT

  • Physical Therapist
  • Murrieta, CA
National Provider Identifier
1871577759
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT22506 Issued in CA
Practice address
26755 Jefferson Ave Ste D-1
Murrieta, CA 92562-8924
Phone
(951) 574-6300
Fax
(951) 574-6301
NPI assigned
Dec 3, 2005
Last updated
Aug 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT22506 CA Primary

Addresses

Primary practice location

26755 Jefferson Ave Ste D-1
Murrieta, CA 92562-8924

Mailing address

23100 Eucalyptus Ave Ste C
Moreno Valley, CA 92553-5439
Phone (951) 660-4532

Other practice location 1

277 Rancheros Dr Ste 150
San Marcos, CA 92069-2976
Phone (442) 385-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080303000431 CA Practitioner - Physical Therapist in Private Practice 4486738291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green Physical Therapy IncGroup PAC ID 5597027581, 15 clinicians

Practice addresses (Care Compare)

32605 Temecula Pkwy
Suite 103
Temecula, CA 92592-6838
Phone (951) 331-3660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT22506CAMDPhysical Therapist
22506CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Green Physical Therapy, Inc. Physical Therapist CurrentSince Nov 4, 2021 Accepting new patients
Walker Physical Therapy, Inc Physical Therapist PastSince Sep 23, 2004 Accepting new patients

Locations

2091 W Florida Ave
Ste 210
Hemet, CA 92545
Phone (951) 574-6300

29791 Haun Rd
Ste 102
Menifee, CA 92586
Phone (951) 290-7145

23100 Eucalyptus Ave
Ste C
Moreno Valley, CA 92553
Phone (951) 379-1500

26755 Jefferson Ave
Ste D1
Murrieta, CA 92562
Phone (951) 574-6300

277 Rancheros Dr
Ste 150
San Marcos, CA 92069
Phone (760) 750-1902

32605 Temecula Pkwy
Ste 103
Temecula, CA 92592
Phone (951) 331-3660

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1133568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1871577759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23100 EUCALYPTUS AVE STE C",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925535439",
            "telephone_number": "951-660-4532",
            "fax_number": "951-379-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26755 JEFFERSON AVE STE D-1",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925628924",
            "telephone_number": "951-574-6300",
            "fax_number": "951-574-6301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "277 Rancheros Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "San Marcos",
            "state": "CA",
            "postal_code": "920692976",
            "country_code": "US",
            "telephone_number": "442-385-5700",
            "fax_number": "951-379-1501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "LISA",
        "middle_name": "KIMBERLY",
        "credential": "PT MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-03",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT22506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; 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.