Active NPI
McKenna Lise Anderson, MPT
- Physical Therapist
- Culver City, CA
National Provider Identifier
1942508387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 37625
- Practice address
- 6133 Bristol Pkwy
Suite 200
Culver City, CA 90230-6609 - Phone
- (310) 337-7600
- NPI assigned
- Mar 9, 2011
- 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 | PT 37625 | CA | Primary |
Addresses
Primary practice location
6133 Bristol Pkwy
Suite 200
Culver City, CA 90230-6609
Mailing address
4908 Valley Ridge Ave
Los Angeles, CA 90043-1029
Phone (323) 294-7671
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 |
|---|---|---|---|
| 37625 | CA | MD | General Practice Dentistry |
| PT 37625 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299628800000",
"number": "1942508387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4908 VALLEY RIDGE AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900431029",
"telephone_number": "323-294-7671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6133 BRISTOL PKWY",
"address_2": "SUITE 200",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902306609",
"telephone_number": "310-337-7600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "MCKENNA",
"middle_name": "LISE",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-09",
"last_updated": "2011-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 37625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.