Blaine M Lisner, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

25368 Issued in KY

Practice address

3747 Diann Marie Rd
Louisville, KY 40241

Phone

(502) 426-9200

Fax

(502) 426-9259

NPI assigned

Aug 1, 2006

Last updated

Aug 5, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dynamic Medical and Rehab, LLC

  • Durable Medical Equipment & Medical Supplies
  • Louisville, KY
  • NPI 1245606631
  NPD Authorized official
• Dynamic Medical and Rehab PLLC

  • Neurology Physician
  • Louisville, KY
  • NPI 1417256710
  Authorized official Same address or phone
• Injury-Care Associates and Chiropractic Center of Ky LLC

  • Chiropractor
  • Louisville, KY
  • NPI 1851542195

  Neurology

  NPD (past)
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1629085949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 CHAMBERLAIN LANE",
            "address_2": "SUITE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402412091",
            "telephone_number": "502-426-9200",
            "fax_number": "502-426-9259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3747 DIANN MARIE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40241",
            "telephone_number": "502-426-9200",
            "fax_number": "502-426-9259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISNER",
        "first_name": "BLAINE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2021-08-05",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "25368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00230839",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "279500",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036065238 2",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa C. Steelsmith, Psy.D., PLLC (Steelsmith Psychology)
• Lisa Carter Harris Arnp PLLC
• Lisa N. Sheff, LLC
• Lisa V. Hardin Psy.D., LLC
• Lisanne S. Craven and Associates, PLLC
• Alla Lisova, APRN
• Listen Hear LLC (Miracle Ear)
• Listen Hear LLC (Miracle Ear)
• Listen Hear LLC (Miracle Ear)
• Sally Cullen Lister, PH.D.

• Neurology Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Neurology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.