Individual provider Active NPI

Meghan Elizabeth Kissinger, PTA

  • Physical Therapy Assistant
  • Myerstown, PA
National Provider Identifier
1053989608
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
TEI005581 Issued in PA
Practice address
7 W Park Ave
Myerstown, PA 17067-1340
Phone
(717) 628-5502
NPI assigned
Jun 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TEI005581 PA Primary

Addresses

Primary practice location

7 W Park Ave
Myerstown, PA 17067-1340

Mailing address

7 W Park Ave
Myerstown, PA 17067-1340
Phone (717) 628-5500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stoneridge.townecentre@selectrehab.com Direct Select Rehabilitation

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
TEI005581PAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1053989608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 W PARK AVE",
            "city": "MYERSTOWN",
            "state": "PA",
            "postal_code": "170671340",
            "telephone_number": "717-628-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 W PARK AVE",
            "city": "MYERSTOWN",
            "state": "PA",
            "postal_code": "170671340",
            "telephone_number": "717-628-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSINGER",
        "first_name": "MEGHAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI005581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stoneridge.townecentre@selectrehab.com",
            "affiliation": "Y",
            "endpointDescription": "Director of Rehab email",
            "affiliationName": "Select Rehabilitation",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7 W Park Ave",
            "city": "Myerstown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170671340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Myerstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.