Lisa A Myers

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA00587800 Issued in NJ

Practice address

313 Beebe Run Rd
Bridgeton, NJ 08302-5680

Phone

(856) 453-1485

NPI assigned

Nov 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Lisa A Donnelly Former name

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fox Rehabilitation Services Inc

  • Physical Therapist
  • Wilmington, DE
  • NPI 1326092503

  NJ

  Medicare reassignment NPD

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1932276714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 BEEBE RUN RD",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083025680",
            "telephone_number": "856-453-1485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 BEEBE RUN RD",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083025680",
            "telephone_number": "856-453-1485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00587800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "DONNELLY",
            "middle_name": "A",
            "prefix": "MRS.",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Bridgeton, NJ
• Providers in Bridgeton, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.