Individual provider Active NPI

Lyndsey Kiah, PT

  • Physical Therapist
  • MC Lean, VA
National Provider Identifier
1184850174
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9739 Issued in GA
Practice address
1978 Massachusetts Ave
MC Lean, VA 22101-4910
Phone
(678) 427-7540
NPI assigned
Jun 3, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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 2305205362 VA
Physical Therapist 225100000X 9739 GA Primary

Addresses

Primary practice location

1978 Massachusetts Ave
MC Lean, VA 22101-4910

Mailing address

1550 Greyfield Trce
Snellville, GA 30078-5972
Phone (678) 427-7540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241025003382 GA Practitioner - Physical Therapist in Private Practice 6608309893

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9739GAMDPhysical Therapist
2305205362VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Georgia, LLC Physical Therapist CurrentSince Aug 13, 2024 Accepting new patients

Locations

5610 Hampton Park Dr
Cumming, GA 30041
Phone (470) 866-5540

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1184850174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 GREYFIELD TRCE",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785972",
            "telephone_number": "678-427-7540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1978 MASSACHUSETTS AVE",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221014910",
            "telephone_number": "678-427-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIAH",
        "first_name": "LYNDSEY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305205362",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "9739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Lean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.