Lisa Kaye Malsom, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

03303 Issued in IA

Practice address

4911 SW 19TH Street
Des Moines, IA 50315

Phone

(515) 285-2559

NPI assigned

Jun 2, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa Kaye Retzer-Malsom Professional name

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Blue Stone Therapy Inc.

  • Physical Medicine & Rehabilitation Physician
  • Urbandale, IA
  • NPI 1932797297
  Medicare reassignment NPD

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1255599635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4911 SW 19TH STREET",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "50315",
            "telephone_number": "515-285-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4911 SW 19TH STREET",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "50315",
            "telephone_number": "515-285-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALSOM",
        "first_name": "LISA",
        "middle_name": "KAYE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "RETZER-MALSOM",
            "middle_name": "KAYE",
            "credential": "PT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Tamer Ayad Malik, MD
• Tayyaba Maqbool Malik, MD
• Addison Jane Malinski, LMSW
• Thomas A. Mallisee III, M.D.
• Samantha L. Mallory, MD
• Thomas Joseph Maly, LISW
• Denise M Mandi, DPM
• Stephen R Mandler, D.O.
• Vincent Mandracchia, DPM
• Jared Mangels

• Physical Therapist in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.