Lisa Marie Kennedy-Leary, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2477 Issued in OR

Practice address

1441 SW Chandler Ave
Suite 103
Bend, OR 97702-3221

Phone

(541) 312-2252

NPI assigned

May 2, 2007

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 identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1991

Medicare assignment

May accept Medicare assignment

Group practices

Hands on Physical Therapy, PCGroup PAC ID 9537173034, 6 clinicians

Practice addresses (Care Compare)

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.

• Hands on Physical Therapy, PC

  • Orthopedic Physical Therapist
  • Bend, OR
  • NPI 1912129073
  Medicare reassignment Care Compare group NPD Authorized official
• Sarah Peterson LCSW LLC

  • Mental Health Counselor
  • Bend, OR
  • NPI 1316503105
  NPD
• Blair Investments Inc

  • Physical Therapy Clinic/Center
  • Cheyenne, WY
  • NPI 1912052242

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362700800000",
    "number": "1457572554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 SE TEAKWOOD DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022303",
            "telephone_number": "541-382-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 SW CHANDLER AVE",
            "address_2": "SUITE 103",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023221",
            "telephone_number": "541-312-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY-LEARY",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2013-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "2477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN",
            "identifier": "840574002",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFIC SOURCE PIN",
            "identifier": "J6507-02",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsey Rhodes Kelly, RDN
• Crystal Kelso, DMD
• Kemple Memorial Children'S Dental Clinic
• Cheryl L Kemry, LMT
• Fredrick Frank Kennaday, RN
• Kenya Marie Kennedy, LMT
• Kindra Michelle Kennedy, CPM, LDM, IBCLC
• Larry Kennedy, CRM
• Tracy Kennelley, P.A-C
• Kenneth M. Shirtcliff D.M.D. P.C.

• Physical Therapist in Bend, OR
• Providers in Bend, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; 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.