Individual provider Active NPI

Justin David Isiah King, DPT

  • Physical Therapist
  • Evansville, IN
National Provider Identifier
1346800398
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
225 Crosslake Dr
Evansville, IN 47715-8198
Phone
(812) 476-0409
Fax
(812) 476-1016
NPI assigned
Jun 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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 Primary

Addresses

Primary practice location

225 Crosslake Dr
Evansville, IN 47715-8198

Mailing address

PO Box 5629
Evansville, IN 47716-5629
Phone (818) 759-7475

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190930000715 IN Practitioner - Physical Therapist in Private Practice 2365772613 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Western University of Health Sciences College of Dental Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prorehab IncGroup PAC ID 1254317217, 81 clinicians

Practice addresses (Care Compare)

415 Crosslake Dr
Suite B
Evansville, IN 47715-8263
Phone (812) 476-0409

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedics-Indianapolis, Inc CurrentSince Jul 1, 2025 Accepting new patients
Tri-State Orthopaedic Surgeons, Inc. Current Accepting new patients
Orthopaedics-Indianapolis, Inc Physical Therapist Current Accepting new patients
Tri-State Orthopaedic Surgeons, Inc. Physical Therapist CurrentSince Aug 19, 2019 Accepting new patients
Orthopaedics-Indianapolis, Inc CurrentSince Jul 1, 2025 Accepting new patients
Tri-State Orthopaedic Surgeons, Inc. CurrentSince Aug 19, 2019 Accepting new patients
Prorehab Inc Physical Therapist CurrentSince Aug 19, 2019 Accepting new patients
Prorehab Inc Physical Therapist CurrentSince Aug 19, 2019 Accepting new patients

Locations

225 Crosslake Dr
Evansville, IN 47715
Phone (812) 471-6677

5625 Pearl Dr
Ste 100
Evansville, IN 47712
Phone (812) 759-7493

415 Crosslake Dr
Ste B
Evansville, IN 47715
Phone (812) 476-0764

5625 Pearl Dr
Ste 101
Evansville, IN 47712
Phone (812) 474-3800

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1346800398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5629",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477165629",
            "telephone_number": "818-759-7475",
            "fax_number": "812-401-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CROSSLAKE DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477158198",
            "telephone_number": "812-476-0409",
            "fax_number": "812-476-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JUSTIN",
        "middle_name": "DAVID ISIAH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-20",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 23, 2019; 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.