John Listerud, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD069338L Issued in PA

Practice address

3535 Market St FL 3
Philadelphia, PA 19104-3317

Phone

(866) 301-4724

NPI assigned

Sep 22, 2006

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508965559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 PINE ST APT F305",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191436805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 MARKET ST FL 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043317",
            "telephone_number": "866-301-4724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISTERUD",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD069338L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca S Lisowski, CRNP
• Benjamin Liss, M.D.
• Ira Liss, DMD
• Nadia A Liss, DMD
• Nathan Liss, MD
• Mary Katherine Liszka, DPT
• Joan Ava Lit, MD
• Jeffrey Litchauer, PTA
• Lev Litichevskiy, MD, PHD
• Danielle Nicole Litman, DMD

• Psychiatry Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.