Lisa A Long, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0400067001 Issued in VT

Practice address

1282 Main St
Fairfax, VT 05454-9534

Phone

(802) 849-9308

NPI assigned

Sep 15, 2010

Last updated

Sep 15, 2010By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Fairfax Family Physical Therapy P.C.

  dba Fairfax Family Physical Therapy P.C. DME

  • Durable Medical Equipment & Medical Supplies
  • Fairfax, VT
  • NPI 1477706257
  NPD (past)
• Fairfax Family Physical Therapy, P.C.

  • Physical Therapist
  • Fairfax, VT
  • NPI 1275797276
  NPD (past)

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

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1942518717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1889 VT ROUTE 128",
            "city": "WESTFORD",
            "state": "VT",
            "postal_code": "054949611",
            "telephone_number": "802-881-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1282 MAIN ST",
            "city": "FAIRFAX",
            "state": "VT",
            "postal_code": "054549534",
            "telephone_number": "802-849-9308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "0400067001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Franklin West Supervisory Union
• Maegan Garrett, LICSW
• Krystal Jenness, PT
• Melissa Laflin, PT, DPT, ATC
• Jacquelyn Lewis, LMT, NCTMB, CCA
• Teig D Marco, M.D.
• John Paul Marriott, ND
• Liana Merkel, DPT
• Kristen Nicole Merrill, PT
• Northwestern Medical Center, Inc. (Northwestern Georgia Health Center)

• Physical Therapist in Fairfax, VT
• Providers in Fairfax, VT by specialty
• Physical Therapist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.

Verify at the official NPI Registry.