MRS. LARISSA GIZELLE NEAL (NPI# 1053579250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053579250 |
| Entity Type | Individual |
| Full Name | MRS. LARISSA GIZELLE NEAL |
| Practice Address |
1640 Redstone Center Dr 200 Park City UT 84098-7605 |
| Mailing Address |
44863 Milestone Sq 302 Ashburn VA 20147-4203 |
| Practice Telephone | 8888008744 |
| Mailing Telephone | 7037297311 |
| Enumeration Date | 2008-05-26 |
| Last Update Date | 2008-05-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251G0304X |
Physical Therapist Specialization: Geriatrics |
2305204903 | VA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1640 REDSTONE CENTER DR 200 |
| City | PARK CITY |
| State | UT |
| Zip Code | 84098-7605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255470779 | Sheetal Yogesh Jhaveri | Physical Therapist | 1640 Redstone Center Dr, Suite 200, Park City, UT 84098-7605 | 2007-02-05 |
| 1518593110 | Bertram Pride | Licensed Practical Nurse | 1640 Redstone Center Dr, Park City, UT 84098-7605 | 2020-03-16 |
| 1356988141 | Janet Mary Barmeier | Speech-Language Pathologist | 1640 Redstone Center Dr, Park City, UT 84098-7605 | 2019-11-29 |
| 1346806551 | Shabrittany Williams | Physical Therapy Assistant | 1640 Redstone Center Dr, Park City, UT 84098-7605 | 2019-05-13 |
| 1336508696 | Kate Wigman | Physical Therapy Assistant | 1640 Redstone Center Dr, Suite 200, Park City, UT 84098-7605 | 2016-02-15 |
| 1811368087 | Laura Ely | Occupational Therapist | 1640 Redstone Center Dr, Suite 200, Park City, UT 84098-7605 | 2015-10-14 |
| 1346616596 | Darrell Larry | Occupational Therapist | 1640 Redstone Center Dr, Suite 200, Park City, UT 84098-7605 | 2015-08-11 |
| 1699174615 | Jasima Reynolds | Home Health | 1640 Redstone Center Dr, Suite 200, Park City, UT 84098-7605 | 2014-08-14 |
| 1609275809 | Ryan Robert Holzum | Physical Therapist | 1640 Redstone Center Dr, Park City, UT 84098-7605 | 2014-08-14 |
| 1518215821 | Mona Kazemi | Occupational Therapist | 1640 Redstone Center Dr, Suite 200, Park City, UT 84098-7605 | 2012-08-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972069532 | Natasha Nicolle Peterson | Nurse Practitioner | Stat Md, 1784 Uinta Way E, Park City, UT 84098 | 2019-02-19 |
| 1750732079 | Rebecca Hansen | Physical Therapist | 1640 W Redstone Center Dr, Suite 200, Park City, UT 84098 | 2016-06-28 |
| 1497126130 | Megan Franz | Counselor | 3100 Pinebrook Rd, Park City, UT 84098 | 2015-10-07 |
| 1568752541 | Kortney James Stirland | Pharmacist | 750 Round Valley Drive #203, Park City, UT 84098 | 2011-04-12 |
| 1265763379 | Amy S Koch | Physical Therapy Assistant | 1640 West Redstone Drive, Suite 200, Park City, UT 84098 | 2010-01-29 |
| 1134374648 | Donna B Fischer | General Practice | 6531 N Landmark Dr., Park City, UT 84098 | 2008-11-25 |
| 1962659458 | Patricia A Lindsay Phd Inc | Psychologist | 1743 W Redstone Ctr Dr, #115, Park City, UT 84098 | 2008-08-26 |
| 1437314291 | Jeffrey S Holverson | Internal Medicine | 6240 N Snowview Dr, Park City, UT 84098 | 2008-07-22 |
| 1578728515 | Blair Archbold Smith | Physical Therapist | 6880 Canyon Drive Court, Park City, UT 84098 | 2008-07-18 |
| 1821255274 | Beth Anita Rylands | Physical Therapy Assistant | 1640 W. Redstone Center Dr., Suite 200, Park City, UT 84098 | 2008-05-21 |
| Find all providers in zip 84098 | ||||
| Taxonomy Code | 2251G0304X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Geriatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811338445 | Kenneth Tillman Ethington Jr. | Physical Therapist | 2707 S Adams St Apt 3, Salt Lake City, UT 84115-3350 | 2013-07-11 |
| 1700125861 | Timothy Fay Hunt | Physical Therapist | 3801 S Highland Cove Ln, #329, Salt Lake City, UT 84106-4223 | 2013-02-10 |
| 1124148754 | Wesley Paul Walker | Physical Therapist | 3086 W Eugene Hill Way, Taylorsville, UT 84129-2290 | 2007-03-29 |
| 1902454531 | Catherine Champlin | Physical Therapist | 411 W 1325 N, Cedar City, UT 84721-7720 | 2019-08-27 |
| 1326541145 | Robert Chynoweth | Physical Therapist | 1250 E 3900 S Ste 440, Salt Lake City, UT 84124-1349 | 2018-03-18 |
| 1487000287 | University of Utah Adult Services | Physical Therapist | 520 S Wakara Way, Salt Lake City, UT 84108-1213 | 2016-05-11 |
| 1467746073 | Mark Orlo Walker | Physical Therapist | 1216 E 1300 S, Salt Lake City, UT 84105-1949 | 2011-06-01 |
| 1992952337 | Jennifer Kalasky Nelson | Physical Therapist | 4600 Highland Dr, Salt Lake City, UT 84117-5108 | 2008-08-27 |
| 1972713329 | Therapeak, Inc. | Physical Therapist | 4001 S 700 E, Suite 500, Salt Lake City, UT 84107-2177 | 2007-05-23 |
| 1508981630 | Denise C Winters | Physical Therapist | 1952 Fort Union Blvd, Salt Lake City, UT 84121-6877 | 2007-03-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.