Active NPI
Patrick Michael Lister Jr., PTA
- Physical Therapy Assistant
- Middletown, PA
National Provider Identifier
1962808899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- TEI003819
- Practice address
- 649 Hoffer St
Middletown, PA 17057-2836 - Phone
- (717) 574-3412
- NPI assigned
- Nov 4, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | TEI003819 | PA | Primary |
Addresses
Primary practice location
649 Hoffer St
Middletown, PA 17057-2836
Mailing address
649 Hoffer St
Middletown, PA 17057-2836
Phone (717) 574-3412
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TEI003819 | PA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415059200000",
"number": "1962808899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "649 HOFFER ST",
"city": "MIDDLETOWN",
"state": "PA",
"postal_code": "170572836",
"telephone_number": "717-574-3412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "649 HOFFER ST",
"city": "MIDDLETOWN",
"state": "PA",
"postal_code": "170572836",
"telephone_number": "717-574-3412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LISTER",
"first_name": "PATRICK",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-11-04",
"last_updated": "2014-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "PA",
"license": "TEI003819",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.