Steve Logan Kish, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT39735 Issued in FL

Practice address

534 S 5TH St Ste a
Macclenny, FL 32063-2602

Phone

(904) 259-1649

NPI assigned

Oct 13, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nesin Therapy Services, P.C.Group PAC ID 4082697040, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Nesin Therapy Services, P.C.

  • Physical Therapy Clinic/Center
  • Madison, AL
  • NPI 1417021320
  Medicare reassignment Care Compare group NPD
• John Goetze Physical Therapy, Inc

  • Physical Therapist
  • Macclenny, FL
  • NPI 1568533172
  NPD (past)

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1851053169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 S 5TH ST STE A",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632602",
            "telephone_number": "904-259-1649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 S 5TH ST STE A",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632602",
            "telephone_number": "904-259-1649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISH",
        "first_name": "STEVE",
        "middle_name": "LOGAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-13",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH10495",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT39735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John J Coleman DPM
• Garri Renee Johns, FNP-BC
• Josue Jorge Caraballo, M.D.
• Kelli K Kanemaru-Takeuchi, DDS
• Pushpjeet Singh Kanwar, M.D
• Kla Enterprises, LLC Dba Luxe Health & Wellness
• Kyle Monroe Knabb, DO
• Sergio M Lagman, M.D.
• Ly C Lam, MD
• Tracy Yvonne Langston

• Physical Therapist in Macclenny, FL
• Providers in Macclenny, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.

Verify at the official NPI Registry.