Lauren C Kisan, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

401 W McGalliard Rd
Muncie, IN 47303-1828

Phone

(765) 288-6200

Fax

(765) 288-4131

NPI assigned

Sep 11, 2023

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

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifetime Skin Care Centers, LLCGroup PAC ID 1254306574, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Lifetime Skin Care Centers, LLC

  dba Lifetime Skin Care Centers

  • Dermatology Physician
  • Muncie, IN
  • NPI 1902861016
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1407633894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W MCGALLIARD RD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473031828",
            "telephone_number": "765-288-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W MCGALLIARD RD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473031828",
            "telephone_number": "765-288-6200",
            "fax_number": "765-288-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISAN",
        "first_name": "LAUREN",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kingdom Wellness Counseling and Mentoring Center
• Rosemary L Kirby, OTR
• Charles Kirk Sr.
• Dafina Kirk
• Shelby Kirts, DDS
• Robyn Kittrell, PHD HSPP
• Coresa Klein, CCP
• Jessica Knapp, NP
• Lorien Knapp, NP
• Eva Knight

• Physician Assistant in Muncie, IN
• Providers in Muncie, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.