Benjamin Kissick, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

05012965A Issued in IN

Practice address

590 Pit Rd
Brownsburg, IN 46112-7830

Phone

(317) 456-1056

NPI assigned

Aug 20, 2015

Last updated

Dec 3, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. Vincent Hospital & Health Care Center, Inc.

  dba Ascension St. Vincent Pharmacy

  • Community/Retail Pharmacy
  • Indianapolis, IN
  • NPI 1194929646
  NPD (past)

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1437525722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 PIT RD",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461127830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 PIT RD",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461127830",
            "telephone_number": "317-456-1056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9512 Dorchester Rd",
            "address_2": "Suite 140",
            "address_purpose": "LOCATION",
            "city": "Summerville",
            "state": "SC",
            "postal_code": "294854305",
            "country_code": "US",
            "telephone_number": "843-695-7970",
            "fax_number": "843-695-7971",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1185 W Carmel Dr Bldg C",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460328708",
            "country_code": "US",
            "telephone_number": "317-415-6980",
            "fax_number": "317-415-6990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISSICK",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-20",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1265739",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "7849",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IN",
            "license": "05012965A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopedic Physical Therapist in Brownsburg, IN
• Providers in Brownsburg, IN by specialty
• Orthopedic Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.