Ilissa L Raymond, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P12321 Issued in NC

Practice address

500 Academy St S
Ahoskie, NC 27910-3248

Phone

(252) 209-3784

NPI assigned

Feb 10, 2011

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1297296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297296000000",
    "number": "1992001812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 LOGAN ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149011933",
            "telephone_number": "607-426-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ACADEMY ST S",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279103248",
            "telephone_number": "252-209-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYMOND",
        "first_name": "ILISSA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-10",
        "last_updated": "2011-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P12321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Ahoskie, NC
• Providers in Ahoskie, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.

Verify at the official NPI Registry.