Kieran Lyssa Nashan

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

60480124 Issued in WA

Practice address

104 Centennial Dr Ste 101
Livingston, MT 59047-8101

Phone

(406) 222-0366

Fax

(406) 222-0366

NPI assigned

Jul 21, 2014

Last updated

Apr 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Kieran McKinnell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Yellowstone Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Livingston, MT
  • NPI 1841322310

  Physical Therapist

  NPD
• Therapeutic Associates Inc

  dba TAI - North Creek

  • Physical Therapist
  • Bothell, WA
  • NPI 1114376563
  NPD (past)
• Therapeutic Associates Inc

  dba TAI Cedar Hills Physical Therapy

  • Physical Therapist
  • Portland, OR
  • NPI 1700862000
  NPD (past)

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1942617188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD",
            "address_2": "SUITE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "800-219-8835",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CENTENNIAL DR STE 101",
            "city": "LIVINGSTON",
            "state": "MT",
            "postal_code": "590478101",
            "telephone_number": "406-222-0366",
            "fax_number": "406-222-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASHAN",
        "first_name": "KIERAN",
        "middle_name": "LYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-21",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "PTP-PT-LIC-9425",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "60480124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2039509",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942617188",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01476740",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIERAN",
            "last_name": "MCKINNELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ellen Elizabeth Morris, LCSW
• Mountain Country Women's Clinic
• Mountain Wellness Therapy LLC
• Deeann Marie Myer, MS, LCSW
• Diane Nash Boehm, L.C.P.C.
• Emma Taylor Neal, MS OTR/L
• Danny F. Neill, HEARING INSTRUMENT S
• Haley Nelson, MS, LCPC
• April Neptune
• Debra J Netley, CMT

• Physical Therapist in Livingston, MT
• Providers in Livingston, MT by specialty
• Physical Therapist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.