Lisa Vivian, R.P.T.
Individual provider Active NPI Physical Therapist · Springfield, MA
NPI 1912997271 · NPPES record last updated Jun 5, 2014
Key facts
- NPI
- 1912997271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 5487 (MA)
- Practice address
- 933 E Columbus Ave
Springfield, MA 01105-2509 - Phone
- (413) 301-6019
- NPI assigned
- Oct 26, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007615 | CT | MD | Physical Therapist |
| 5487 | MA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ergonomic Collaboration Group, LLC | Past | Accepting new patients | |
| United Physical Therapy | Physical Therapist | Past | Accepting new patients |
| Action Chiropractic & P.T., Inc. | Physical Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5487 | MA | Yes |
| Physical Therapist | 225100000X | 007615 | CT |
Addresses
Primary practice location
933 E Columbus Ave
Springfield, MA 01105-2509
Mailing address
933 E Columbus Ave
Springfield, MA 01105-2509
Phone (413) 301-6019
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0365611 | Medicaid | MA | |
| Y66095 | Other | MA | BLUECROSS/BLUESHIELD |
Other providers in Springfield, MA
- Erin Kathleem Vitorino
- Vituity-Massachusetts PLLC
- Jennifer Sophia Viveiros
- Tara Marie Vivenzio
- Gail Anne Vivian
- Suong T Vo
- Claudia Rebekka Vogelgsang
- Iqra Vohra
- Moises Volquez
- Sclansky Voltaire
All providers in Springfield, MA · Physical Therapist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.