LISA WILDS (NPI# 1134120116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134120116 |
| Entity Type | Individual |
| Full Name | LISA WILDS |
| Credential | PT,OCS,CERT.MDT,COMT |
| Practice Address |
420 Bainbridge St Philadelphia PA 19147-1568 |
| Mailing Address |
235 Harwicke Rd Springfield PA 19064-3101 |
| Practice Telephone | 2156291270 |
| Practice Fax Number | 2156295531 |
| Mailing Telephone | 6105431493 |
| Mailing Fax Number | 2156291293 |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | PT009484-L | PA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | PT LICENSE NUMBER | PT009484-L | 01 |
| Street Address |
420 BAINBRIDGE ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19147-1568 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588661235 | Orthopedic and Sports Physical Therapy Services, Inc. | Physical Therapist | 420 Bainbridge St, Philadelphia, PA 19147-1568 | 2005-07-07 |
| 1922517036 | Alexis Dispenziere | Physical Therapist | 420 Bainbridge St, Philadelphia, PA 19147-1568 | 2017-09-21 |
| 1730622499 | Emily Chappell | Physical Therapist | 420 Bainbridge St, Philadelphia, PA 19147-1568 | 2016-11-29 |
| 1811373996 | John Zegar | Physical Therapist | 420 Bainbridge St, Philadelphia, PA 19147-1568 | 2015-07-30 |
| 1295141828 | Rachel Braman | Physical Therapist | 420 Bainbridge St, Philadelphia, PA 19147-1568 | 2014-07-02 |
| 1982999561 | Antonio Greco | Physical Therapist | 420 Bainbridge St, Philadelphia, PA 19147-1568 | 2011-06-13 |
| 1437449204 | Christine Vanderwyden | Physical Therapist | 420 Bainbridge St, Philadelphia, PA 19147-1568 | 2011-04-14 |
| 1225327869 | Caitlin Higgins | Physical Therapist | 420 Bainbridge St, Philadelphia, PA 19147-1568 | 2011-04-05 |
| 1780984559 | Adam Kessel | Physical Therapist | 420 Bainbridge St, Philadelphia, PA 19147-1568 | 2010-10-27 |
| 1003134826 | Meredith Mayes | Physical Therapist | 420 Bainbridge St, Philadelphia, PA 19147-1568 | 2010-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508336181 | Jamica Cropper-pam | Counselor | 401 S 2nd St. Suite 301, Philadelphia, PA 19147 | 2018-11-27 |
| 1598234411 | Halina Dziewolska | Behavioral Analyst | 535 Queen Street, Philadelphia, PA 19147 | 2018-11-20 |
| 1972072908 | City Dental LLC | Clinic/Center | 1100 Washington Ave 2nd Floor, Philadelphia, PA 19147 | 2018-11-20 |
| 1487120218 | Christopher Michael Rosado | Behavioral Analyst | 1218-20 South 8th St, 1, Philadelphia, PA 19147 | 2018-10-19 |
| 1891271722 | Candice Millard | Dietitian, Registered | 419 S 8th St Apt 1b, Philadelphia, PA 19147 | 2018-07-13 |
| 1669998217 | Julianne Leonarda Wiebalk | Counselor | 814 South 4th Street, 1st Floor, Philadelphia, PA 19147 | 2017-08-16 |
| 1396269247 | Sara Parente | Social Worker | 1217 Fitzwater St., Unit A, Philadelphia, PA 19147 | 2017-08-02 |
| 1609398445 | Nikele Riek | Social Worker | 1348 Bainbridge Street, Philadelphia, PA 19147 | 2017-07-13 |
| 1023556875 | Bralow Medical Group | General Practice | 834 South St., Philadelphia, PA 19147 | 2017-02-01 |
| 1194196105 | Ann Courto | Dietitian, Registered | 1140 Cross Street, Philadelphia, PA 19147 | 2015-10-16 |
| Find all providers in zip 19147 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174156012 | Sade Yolanda Davis | Specialist | 2414 N Garnet St, Philadelphia, PA 19132-3725 | 2020-02-19 |
| 1356803993 | Larkerra Goodson | Specialist | 1336 Arrott St Apt E15, Philadelphia, PA 19124-3281 | 2019-04-03 |
| 1306302617 | Keisha Robinson | Specialist | 6852 Regent St, Philadelphia, PA 19142-1213 | 2019-02-12 |
| 1740758168 | William Whitaker | Specialist | 1115 E Sanger St, Philadelphia, PA 19124-1130 | 2018-11-02 |
| 1902395536 | Ran Barzilay | Specialist | 3440 Market St, Suite 200, Philadelphia, PA 19104 | 2018-05-09 |
| 1093229668 | Danielle M Marshall | Specialist | 514 Seville St Apt 7, Philadelphia, PA 19128-2737 | 2017-11-19 |
| 1336651017 | Radhia Afif | Specialist | 5943 Weymouth St, Philadelphia, PA 19120-1122 | 2017-11-02 |
| 1306383401 | Helping Hair LLC | Specialist | 930 N 50th St, Philadelphia, PA 19131-5102 | 2017-01-26 |
| 1447796172 | Kristen Halvorson | Specialist | 3411 Cresson St, Apartment 6, Philadelphia, PA 19129-1654 | 2017-01-19 |
| 1174079131 | Sadia Randolph | Specialist | 6718 Paschall Ave, Philadelphia, PA 19142-1809 | 2016-08-30 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19147 |
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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.