Individual provider Active NPI

Janna Lee Kissel, PT

  • Physical Therapist
  • Greencastle, IN
National Provider Identifier
1104013770
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05001368A Issued in IN
Practice address
1140 Indianapolis Rd
Greencastle, IN 46135-1458
Phone
(765) 848-1421
Fax
(765) 301-4351
NPI assigned
Sep 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.015963 IL
Physical Therapist 225100000X 05001368A IN Primary

Addresses

Primary practice location

1140 Indianapolis Rd
Greencastle, IN 46135-1458

Mailing address

712 Toddson Dr
Greencastle, IN 46135-9202
Phone (765) 653-6718

Other practice location 1

712 Toddson Dr
Greencastle, IN 46135-9202
Phone (765) 653-6718

Other identifiers 1

IdentifierTypeStateIssuer
05001368AOtherININ LICENSING BOARD

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.015963ILMDPhysical Therapist
05001368AINMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1104013770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 TODDSON DR",
            "city": "GREENCASTLE",
            "state": "IN",
            "postal_code": "461359202",
            "telephone_number": "765-653-6718",
            "fax_number": "765-653-8930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 INDIANAPOLIS RD",
            "city": "GREENCASTLE",
            "state": "IN",
            "postal_code": "461351458",
            "telephone_number": "765-848-1421",
            "fax_number": "765-301-4351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "712 Toddson Dr",
            "address_purpose": "LOCATION",
            "city": "Greencastle",
            "state": "IN",
            "postal_code": "461359202",
            "country_code": "US",
            "telephone_number": "765-653-6718",
            "fax_number": "765-653-8930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISSEL",
        "first_name": "JANNA",
        "middle_name": "LEE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-27",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.015963",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05001368A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN LICENSING BOARD",
            "identifier": "05001368A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greencastle, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; 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.