Individual provider Active NPI

Lorie Makrush

  • Physical Therapist
  • Naples, FL
National Provider Identifier
1992960884
Registry record updated Dec 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT29105 Issued in FL
Practice address
6825 Davis Blvd
Naples, FL 34104
Phone
(239) 455-1459
NPI assigned
Jul 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-1773 ID
Physical Therapist 225100000X PT29105 FL Primary

Addresses

Primary practice location

6825 Davis Blvd
Naples, FL 34104

Mailing address

25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697

Other practice location 1

1952 E 7000 S
Salt Lake City, UT 84121-6877
Phone (801) 942-3311 ext. 127

Other practice location 2

1952 E 7000 S
Salt Lake City, UT 84121-6877
Phone (801) 942-3311 ext. 127

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

LicenseStateTypeSpecialty
PT29105FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544572800000",
    "number": "1992960884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE STE D",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6825 DAVIS BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "34104",
            "telephone_number": "239-455-1459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1952 E 7000 S",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841216877",
            "country_code": "US",
            "telephone_number": "801-942-3311 x127",
            "fax_number": "801-495-5303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1952 E 7000 S",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841216877",
            "country_code": "US",
            "telephone_number": "801-942-3311 x127",
            "fax_number": "801-495-5303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAKRUSH",
        "first_name": "LORIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2018-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-1773",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT29105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2018; 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.