Jenna Anne Lisenby, MSPT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00008530 Issued in WA

Practice address

3927 Rucker Ave
Everett, WA 98201-4833

Phone

(425) 339-5419

NPI assigned

Aug 31, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Optum Care Washington PLLC

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1831186766
  Medicare reassignment NPD
• Jenna Lisenby, DPT, LLC

  • Pediatric Physical Therapist
  • Mount Vernon, WA
  • NPI 1891096194
  NPD Authorized official
• Optum Care Washington PLLC

  • Durable Medical Equipment & Medical Supplies
  • Marysville, WA
  • NPI 1194428425
  NPD

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1932332566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-258-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3927 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014833",
            "telephone_number": "425-339-5419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISENBY",
        "first_name": "JENNA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MSPT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00008530",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "WA",
            "license": "PT00008530",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "WA",
            "license": "PT00008530",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kassandra Lint
• Geoffrey L Linville
• John T Linvog, D.D.S.
• Jarma Lion
• Catherine Lipowski
• Darren J Little, M.D.
• Megan Little, BCBA
• Taylor Little
• Jamie R Litvack, M.D., M.S.
• George J Litz III, PA-C

• Physical Therapist in Everett, WA
• Providers in Everett, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; 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.