Individual provider Active NPI

Christine E Lusk, PTA

  • Physical Therapy Assistant
  • Goshen, IN
National Provider Identifier
1922511039
Registry record updated Nov 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06002443A Issued in IN
Practice address
1615 Winsted Dr Ste 3
Goshen, IN 46526-4673
Phone
(574) 534-4648
Fax
(574) 537-9048
NPI assigned
Nov 10, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 06002443A IN Primary

Addresses

Primary practice location

1615 Winsted Dr Ste 3
Goshen, IN 46526-4673

Mailing address

8259 Wicker Ave
Saint John, IN 46373-8878
Phone (800) 341-1703

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

LicenseStateTypeSpecialty
06002443AINMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510272000000",
    "number": "1922511039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8259 WICKER AVE",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463738878",
            "telephone_number": "800-341-1703",
            "fax_number": "877-719-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 WINSTED DR STE 3",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264673",
            "telephone_number": "574-534-4648",
            "fax_number": "574-537-9048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSK",
        "first_name": "CHRISTINE",
        "middle_name": "E",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-10",
        "last_updated": "2017-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06002443A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2017; 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.