Active NPI
Lisa M Kiesel, MPT
- Physical Therapist
- Evansville, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05006923A
- Practice address
- 7300 E Indiana St
Ste 102
Evansville, IN 47715-2794 - Phone
- (812) 476-0409
- Fax
- (812) 476-1016
- NPI assigned
- Dec 8, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05006923A | IN | Primary |
Addresses
Primary practice location
7300 E Indiana St
Ste 102
Evansville, IN 47715-2794
Mailing address
7300 E Indiana St
Ste 102
Evansville, IN 47715-2794
Phone (812) 476-0409
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000302861 | Other | IN | BLUE CROSS BLUE SHIELD |
| 200839540 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4659 N 1St Ave
Evansville, IN 47710-3625
Phone (812) 759-3001
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05006923A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-State Orthopaedic Surgeons, Inc. | Current | Accepting new patients | |
| Prorehab Inc | Physical Therapist | Current | Accepting new patients |
| Tri-State Orthopaedic Surgeons, Inc. | Current | Accepting new patients | |
| Tri-State Orthopaedic Surgeons, Inc. | Physical Therapist | Current | Accepting new patients |
| Prorehab Inc | Physical Therapist | Current | Accepting new patients |
| Orthopaedics-Indianapolis, Inc | Current | Accepting new patients | |
| Orthopaedics-Indianapolis, Inc | Physical Therapist | Current | Accepting new patients |
| Orthopaedics-Indianapolis, Inc | Current | Accepting new patients |
Locations
4659 N 1st Ave
Evansville, IN 47710
Phone (812) 759-3001
5625 Pearl Dr
Ste 101
Evansville, IN 47712
Phone (812) 474-3800
415 Crosslake Dr
Ste B
Evansville, IN 47715
Phone (812) 476-0764
225 Crosslake Dr
Evansville, IN 47715
Phone (812) 471-6677
7300 E Indiana St
Ste 102
Evansville, IN 47715
Phone (812) 759-7451
8450 Northwest Blvd
Indianapolis, IN 46278
8887 High Pointe Dr
Ste E
Newburgh, IN 47630
Phone (812) 759-7464
2121 Willow St
Vincennes, IN 47591
Phone (812) 882-1141
Interoperability endpoints
- referral4@prorehab-north.direct.kno2fy.com
Organizations & group practices 8
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.
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- Physical Therapist
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Physical Therapist
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- Orthopaedic Surgery Physician
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- NPI 1073622015
-
- Orthopaedic Surgery Physician
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- NPI 1285433953
-
- Durable Medical Equipment & Medical Supplies
- Vincennes, IN
- NPI 1841014933
Physical Therapist
-
- Durable Medical Equipment & Medical Supplies
- Vincennes, IN
- NPI 1699414961
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- Physical Therapist
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- NPI 1730357237
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236816000000",
"number": "1154306660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7300 E INDIANA ST",
"address_2": "STE 102",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477152794",
"telephone_number": "812-476-0409",
"fax_number": "812-476-1016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7300 E INDIANA ST",
"address_2": "STE 102",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477152794",
"telephone_number": "812-476-0409",
"fax_number": "812-476-1016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIESEL",
"first_name": "LISA",
"middle_name": "M",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-08",
"last_updated": "2009-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05006923A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "000000302861",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200839540",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; 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.