Kohl S. Kershisnik, M.P.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305205789 Issued in VA

Practice address

5690 Three Notchd Rd
Suite 107
Crozet, VA 22932-3172

Phone

(434) 823-7628

Fax

(434) 823-7681

NPI assigned

Aug 22, 2006

Sex

Male

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

Not listed in the public Medicare enrollment file

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.

• Advanced Center for Physical Therapy, PLC

  • Physical Therapy Clinic/Center
  • Barboursville, VA
  • NPI 1013169473
  NPD (past)
• Phoenix Rehabilitation and Health Services of Virginia, LLC

  • Physical Therapist
  • Cranberry Township, PA
  • NPI 1336155845
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268611200000",
    "number": "1083720064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5690 THREE NOTCHD RD",
            "address_2": "SUITE 107",
            "city": "CROZET",
            "state": "VA",
            "postal_code": "229323172",
            "telephone_number": "434-823-7628",
            "fax_number": "434-823-7681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5690 THREE NOTCHD RD",
            "address_2": "SUITE 107",
            "city": "CROZET",
            "state": "VA",
            "postal_code": "229323172",
            "telephone_number": "434-823-7628",
            "fax_number": "434-823-7681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSHISNIK",
        "first_name": "KOHL",
        "middle_name": "S.",
        "credential": "M.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2010-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305205789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James W Willis DDS PLC
• Carrie Jones, CCC-SLP
• Gita Karimianpour
• Megan D Kauffmannn
• Catherine Kelly, PT
• Sarah Mi-Yon Kim
• Kristen Knies, DPT
• Joel S. Kovarsky, M.D.
• Stuart Landis, OTR/L
• David M Lewis, LCSW, MSW

• All providers in Crozet, VA
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2010; 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.