Individual provider Active NPI

Lynn Everett Isernia, PT

  • Physical Therapist
  • Latham, NY
National Provider Identifier
1811023294
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
014534 Issued in NY
Practice address
250 Old Loudon Rd
Latham, NY 12110-2909
Phone
(518) 690-4406
Fax
(518) 220-9220
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 014534 NY Primary

Addresses

Primary practice location

250 Old Loudon Rd
Latham, NY 12110-2909

Mailing address

250 Old Loudon Rd
Latham, NY 12110-2909
Phone (518) 489-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140128000257 NY Practitioner - Physical Therapist in Private Practice 6305075151 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014534NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
R.J.N. Physical Therapy P.L.L.C. Physical Therapist CurrentSince Jun 25, 2023 Accepting new patients
Empire Fitness & Physical Therapy Physical Therapist CurrentSince Nov 1, 2013 Accepting new patients

Locations

8 Century Hill Dr
Ste 201
Latham, NY 12110
Phone (518) 690-4406

8 Century Hill Dr
Latham, NY 12110
Phone (518) 783-7173

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.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1811023294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 OLD LOUDON RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102909",
            "telephone_number": "518-489-2020",
            "fax_number": "518-489-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 OLD LOUDON RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102909",
            "telephone_number": "518-690-4406",
            "fax_number": "518-220-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISERNIA",
        "first_name": "LYNN",
        "middle_name": "EVERETT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "014534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.