Molly D Lisenby, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070-013673 Issued in IL

Practice address

5009 N Executive Dr Ste B
Peoria, IL 61614

Phone

(309) 839-8631

Fax

(855) 579-3536

NPI assigned

May 17, 2006

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

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lisenby Physical Therapy for Women IncGroup PAC ID 6103069059, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lisenby Physical Therapy for Women, Inc.

  • Physical Therapy Clinic/Center
  • Peoria, IL
  • NPI 1841638228
  Medicare reassignment Care Compare group Authorized official
• Accelerated Rehabilitation Centers LTD

  • Physical Therapist
  • Westmont, IL
  • NPI 1205875713
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1023060001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5009 N EXECUTIVE DR",
            "address_2": "STE B",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144866",
            "telephone_number": "309-472-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5009 N EXECUTIVE DR STE B",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-839-8631",
            "fax_number": "855-579-3536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "719 W Lake Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616145941",
            "country_code": "US",
            "telephone_number": "309-839-8631",
            "fax_number": "855-579-3536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LISENBY",
        "first_name": "MOLLY",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-013673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doreen L Link, NP
• Laura Ann Baker Lins, MD, MPH, ATC
• Katlyn Linsley, BCBA
• Priscila Lisboa, M.D.
• Lisenby Physical Therapy for Women, Inc.
• Christina Lisowski, APN
• Anna Liszka
• Michelle D Little, APN
• Jaci Litwiller
• Karla Litwiller, RN BSN IBCLC

• Physical Therapist in Peoria, IL
• Providers in Peoria, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.