MR. PHILLIP LIS (NPI# 1811456098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811456098 |
| Entity Type | Individual |
| Full Name | MR. PHILLIP LIS |
| Credential | CPO |
| Practice Address |
950 W Faris Rd Greenville SC 29605-4255 |
| Mailing Address |
Po Box 865109 Orlando FL 32886-5109 |
| Practice Telephone | 8642558761 |
| Mailing Telephone | 8446023960 |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2019-03-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 222Z00000X | Orthotist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 224P00000X | Prosthetist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
950 W FARIS RD |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29605-4255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700845799 | Peter J. Stasikelis | Orthopaedic Surgery | 950 W Faris Rd, Greenville, SC 29605-4255 | 2006-03-20 |
| 1952860157 | Michael Debrouwer | Orthotist | 950 W Faris Rd, Greenville, SC 29605-4255 | 2019-03-18 |
| 1114486529 | Clarissa Rose | Prosthetist | 950 W Faris Rd, Greenville, SC 29605-4255 | 2019-03-15 |
| 1932668340 | Nathan Carter | Orthotist | 950 W Faris Rd, Greenville, SC 29605-4255 | 2019-03-15 |
| 1659830065 | Frank Caruso | Orthotist | 950 W Faris Rd, Greenville, SC 29605-4255 | 2019-03-15 |
| 1679032080 | Elizabeth Gee | Orthotist | 950 W Faris Rd, Greenville, SC 29605-4255 | 2019-03-15 |
| 1770042178 | Megan Mcduffee | Orthotist | 950 W Faris Rd, Greenville, SC 29605-4255 | 2019-03-15 |
| 1134551435 | Karen Shaw | Nurse Practitioner | 950 W Faris Rd, Greenville, SC 29605-4255 | 2013-08-08 |
| 1134566953 | Shriners Hospitals for Children | Orthopaedic Surgery | 950 W Faris Rd, Greenville, SC 29605-4255 | 2013-06-03 |
| 1841536414 | David Raymond Reich | Physician Assistant | 950 W Faris Rd, Greenville, SC 29605-4255 | 2012-12-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205306099 | Prisma Health University Medical Group | Family Medicine | 110 Osage Drive, Greenville, SC 29605 | 2018-12-05 |
| 1306325626 | Lauren Foster Fiscus | Occupational Therapist | 1900 Augusta Street, Suite 2500, Greenville, SC 29605 | 2018-08-08 |
| 1063914372 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1720 Augusta St, Greenville, SC 29605 | 2018-03-02 |
| 1144748385 | Johanna Ruth Henry | Speech-Language Pathologist | 1900 Augusta St., Suite 2500, Greenville, SC 29605 | 2017-09-08 |
| 1477083483 | Alexis Dean Pedigo | Speech-Language Pathologist | 1900 Augusta St, Suite 2500, Greenville, SC 29605 | 2017-06-13 |
| 1134658420 | Trace Christopher Deighan | Obstetrics & Gynecology | 890 West Faris Road, Suite 470, Greenville, SC 29605 | 2017-06-08 |
| 1023569837 | Blessed With Goodness, LLC | In Home Supportive Care | 716 E. Fairfield Road, Unit 120 (mailbox # 14), Greenville, SC 29605 | 2016-10-17 |
| 1972050953 | Suha Umina | Pharmacist | 975 W. Faris Road, Greenville, SC 29605 | 2016-09-07 |
| 1124470976 | Meredith Laine Cavagrotti | Specialist/Technologist | 700 Grove Rd, Greenville, SC 29605 | 2016-07-05 |
| 1205286895 | Med-trans Corporation | Ambulance | 552 Perimeter Rd, Greenville, SC 29605 | 2016-06-15 |
| Find all providers in zip 29605 | ||||
| Taxonomy Code | 224P00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Prosthetist |
| A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912437930 | Coastal Carolina Prosthetics & Orthotics, Inc. | Prosthetist | 1970 W Arlington Blvd Ste A, Greenville, NC 27834-5783 | 2017-06-13 |
| 1164963278 | Travis Petersen | Prosthetist | 835 Johns Hopkins Dr, Suite B, Greenville, NC 27834-7268 | 2017-03-09 |
| 1114486529 | Clarissa Rose | Prosthetist | 950 W Faris Rd, Greenville, SC 29605-4255 | 2019-03-15 |
| 1528572005 | Braden D Teller | Prosthetist | 1025 Wh Smith Blvd Ste 108, Greenville, NC 27834-5278 | 2017-11-20 |
| 1275807174 | Brian Kaluf | Prosthetist | 10 Enterprise Blvd, Suite 206, Greenville, SC 29615-6301 | 2012-02-24 |
| 1649558990 | Brian Mcveigh | Prosthetist | 835 Johns Hopkins Dr Ste B, Greenville, NC 27834-7268 | 2011-08-03 |
| 1295990745 | Steven Joseph Keeton | Prosthetist | 835 Johns Hopkins Dr Ste B, Greenville, NC 27834-7268 | 2008-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932723947 | Jonica D Richardson | Prosthetist | 417 Grand National Ln, Elgin, SC 29045-7113 | 2020-06-04 |
| 1700449964 | Nicole D Jennings | Prosthetist | 920 Saint Andrews Rd Ste 2&3, Columbia, SC 29210-5816 | 2019-04-15 |
| 1629588520 | Adrienne Jackson | Prosthetist | 2005 Old Laurens Rd, Greenwood, SC 29649 | 2017-10-05 |
| 1013465756 | Marquetta Breslin | Prosthetist | 125 Salt Meadow Ln, Summerville, SC 29483-5334 | 2016-09-12 |
| 1457721839 | Richard Goodman II | Prosthetist | 386 Rutt Ln, Goose Creek, SC 29445-7808 | 2015-09-29 |
| 1699153775 | Lisa Burks | Prosthetist | 4026 Ashley Phosphate Rd, Charleston, SC 29418-8547 | 2015-05-11 |
| 1548308695 | Alvin W. Pickering | Prosthetist | 230 Elliott St, Orangeburg, SC 29115-6022 | 2007-02-01 |
| City | GREENVILLE |
| Zip Code | 29605 |
Please comment or provide details below to improve the information on MR. PHILLIP LIS.
| 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.