Lyle David McKissick, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0012179 Issued in CO

Practice address

3801 E Florida Ave
Suite 330
Denver, CO 80210-2571

Phone

(303) 370-2670

Fax

(303) 370-2696

NPI assigned

Jun 14, 2013

Last updated

Oct 17, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Colorado Luna Care Physical Therapy LLCGroup PAC ID 7517363617, 210 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.

• Colorado Luna Care Physical Therapy LLC

  • Physical Therapist
  • Denver, CO
  • NPI 1891461125
  Medicare reassignment Care Compare group NPD
• Intermountain Medical Group Denver, LLC

  • Family Medicine Physician
  • Denver, CO
  • NPI 1083021083
  Medicare reassignment NPD
• Reach Physical Therapy & Wellness

  • Physical Therapy Clinic/Center
  • Centennial, CO
  • NPI 1619775665
  NPD Authorized official
• Intermountain Medical Group Denver, LLC

  dba Orthopedic Centers of Colorado - Saint Joseph

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Denver, CO
  • NPI 1083598874
  NPD
• Intermountain Medical Group Denver, LLC

  dba Midtown Inpatient Medicine

  • Hospitalist Physician
  • Denver, CO
  • NPI 1467081877
  NPD
• Physio Pro, Inc.

  dba Evolution Physical Therapy

  • Physical Therapist
  • Golden, CO
  • NPI 1104573666
  NPD (past)

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

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1932548773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 E FLORIDA AVE.",
            "address_2": "SUITE 330",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80210",
            "telephone_number": "303-370-2670",
            "fax_number": "303-370-2696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 E FLORIDA AVE",
            "address_2": "SUITE 330",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802102571",
            "telephone_number": "303-370-2670",
            "fax_number": "303-370-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKISSICK",
        "first_name": "LYLE",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-14",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0012179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn McKibben
• Laura McKinley, L.AC.
• Susan McKinley, PT, DPT
• Kristin E McKinney, MD
• Linda Ellen McKinzie, LCSW
• Megan Ellyse McKnight, PSYD
• Maggie J McKone, OT
• Leslie McLachlan, PT
• Brenna Goodwin McLain, DDS
• Chelsi Noel McLain, LPC

• Physical Therapist in Denver, CO
• Providers in Denver, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.