Individual provider Active NPI

Robert H Lisenby Jr., DPM

  • Podiatrist
  • Dothan, AL
National Provider Identifier
1861579500
Registry record updated May 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
144 Issued in AL
Practice address
1550 E Main St
Dothan, AL 36301-3012
Phone
(334) 671-1441
Fax
(334) 671-1688
NPI assigned
Nov 1, 2006
Last updated
May 26, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 144 AL Primary

Addresses

Primary practice location

1550 E Main St
Dothan, AL 36301-3012

Mailing address

1550 E Main St
Dothan, AL 36301-3012
Phone (334) 671-1441

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
511GAMDAcupuncturist
144ALMDPodiatrist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243296000000",
    "number": "1861579500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 E MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013012",
            "telephone_number": "334-671-1441",
            "fax_number": "334-671-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 E MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013012",
            "telephone_number": "334-671-1441",
            "fax_number": "334-671-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISENBY",
        "first_name": "ROBERT",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2009-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AL",
            "license": "144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2009; 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.