Individual provider Active NPI

Megan Kisner

  • Physical Therapist
  • Live Oak, TX
National Provider Identifier
1255722849
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1255476 Issued in TX
Practice address
7909 Pat Booker Rd
Live Oak, TX 78233-2602
Phone
(210) 653-2400
Fax
(210) 653-2422
NPI assigned
Feb 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1255476 TX Primary

Addresses

Primary practice location

7909 Pat Booker Rd
Live Oak, TX 78233-2602

Mailing address

7909 Pat Booker Rd
Live Oak, TX 78233-2602
Phone (210) 653-2400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221014001019 UT Practitioner - Physical Therapist in Private Practice 1850618703 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Land Rehabilitation LLCGroup PAC ID 9234048745, 207 clinicians
Registered Physical Therapists IncGroup PAC ID 9537151733, 64 clinicians

Practice addresses (Care Compare)

1950 E Fort Union Blvd
Suite 2
Salt Lake City, UT 84121-6894
Phone (801) 943-1041

9844 S 1300
Suite 200
Sandy, UT 84094-4689
Phone (801) 572-0099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Registered Physical Therapists LLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

9844 S 1300 E
Ste 200
Sandy, UT 84094
Phone (801) 572-0690

9844 S 1300 E
Ste 300
Sandy, UT 84094
Phone (801) 572-0690

4179 S Riverboat Rd
Ste 110
Taylorsville, UT 84123
Phone (801) 337-4475

1577 W 7000 S
Ste 100
West Jordan, UT 84084
Phone (801) 566-6301

Organizations & group practices 2

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": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1255722849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7909 PAT BOOKER RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782332602",
            "telephone_number": "210-653-2400",
            "fax_number": "210-653-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7909 PAT BOOKER RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782332602",
            "telephone_number": "210-653-2400",
            "fax_number": "210-653-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISNER",
        "first_name": "MEGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-18",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1255476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.

Verify at the official NPI Registry.