Active NPI
Lisa McKinney, PT
- Pediatric Physical Therapist
- Bedford, IN
National Provider Identifier
1821384777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 05000767A
- Practice address
- 2137 16TH St
Bedford, IN 47421-3003 - Phone
- (812) 275-5593
- Fax
- (812) 275-5624
- NPI assigned
- Jun 20, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 05000767A | IN | Primary |
Addresses
Primary practice location
2137 16TH St
Bedford, IN 47421-3003
Mailing address
2137 16TH St
Bedford, IN 47421-3003
Phone (812) 275-5593
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05000767A | IN | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308528000000",
"number": "1821384777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2137 16TH ST",
"city": "BEDFORD",
"state": "IN",
"postal_code": "474213003",
"telephone_number": "812-275-5593",
"fax_number": "812-275-5624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2137 16TH ST",
"city": "BEDFORD",
"state": "IN",
"postal_code": "474213003",
"telephone_number": "812-275-5593",
"fax_number": "812-275-5624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKINNEY",
"first_name": "LISA",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-20",
"last_updated": "2011-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "IN",
"license": "05000767A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bedford, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.