Active NPI
Michelle Desjarlais Kistler, P.T.
- Physical Therapist
- Ashland, OR
National Provider Identifier
1619204450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1922
- Practice address
- 208 Oak St Ste 304
Ashland, OR 97520-1872 - Phone
- (541) 292-8505
- NPI assigned
- Nov 16, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1922 | OR | Primary |
Addresses
Primary practice location
208 Oak St Ste 304
Ashland, OR 97520-1872
Mailing address
215 Mobile Dr
Ashland, OR 97520-9021
Phone (541) 292-8505
Other practice location 1
208 Oak St Ste 304
Ashland, OR 97520-1872
Phone (541) 292-8505
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
208 Oak St
Suite 304
Ashland, OR 97520-1872
Phone (541) 292-8505
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1922 | OR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Oregon Sports & Spine PC | Current | Accepting new patients |
Locations
987 Siskiyou Blvd
Ashland, OR 97520
Phone (541) 292-8505
Organizations & group practices 2
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.
-
- Physical Therapist
- Ashland, OR
- NPI 1780912857
-
- Chiropractor
- Ashland, OR
- NPI 1245537521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763596800000",
"number": "1619204450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 MOBILE DR",
"city": "ASHLAND",
"state": "OR",
"postal_code": "975209021",
"telephone_number": "541-292-8505",
"fax_number": "541-482-3364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 OAK ST STE 304",
"city": "ASHLAND",
"state": "OR",
"postal_code": "975201872",
"telephone_number": "541-292-8505"
}
],
"practiceLocations": [
{
"address_1": "208 Oak St Ste 304",
"address_purpose": "LOCATION",
"city": "Ashland",
"state": "OR",
"postal_code": "975201872",
"country_code": "US",
"telephone_number": "541-292-8505",
"fax_number": "541-552-5282",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KISTLER",
"first_name": "MICHELLE",
"middle_name": "DESJARLAIS",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-16",
"last_updated": "2025-11-20",
"certification_date": "2025-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "1922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ashland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; 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.