Individual provider Active NPI

Jennifer Nicole Lisher, DPM

  • Podiatrist
  • Shelbyville, IN
National Provider Identifier
1962434795
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36.003397 Issued in OH
Practice address
275 W Bassett Rd
Shelbyville, IN 46176-8574
Phone
(317) 392-0003
Fax
(317) 392-0003
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 070001053A IN
Podiatrist 213E00000X 36.003397 OH Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 36.003397 OH

Addresses

Primary practice location

275 W Bassett Rd
Shelbyville, IN 46176-8574

Mailing address

275 W Bassett Rd
Shelbyville, IN 46176-8574
Phone (317) 392-0003

Other identifiers 1

IdentifierTypeStateIssuer
200890930MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090415000301 IN Practitioner - Podiatry 4385640671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Major Multispecialty AssociatesGroup PAC ID 6305997842, 39 clinicians

Practice addresses (Care Compare)

2451 Intelliplex Dr
Shelbyville, IN 46176-8581

30 W Rampart St
250 MHP Priority Care
Shelbyville, IN 46176-8897
Phone (317) 398-7644

Hospital & facility affiliations

  • Major Hospital Hospital, Shelbyville, IN, CCN 150097

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070001053AINMDFoot & Ankle Surgery Podiatrist
36.003397OHMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Major Multispecialty Associates Podiatrist CurrentSince Sep 15, 2009 Accepting new patients
Major Multispecialty Associates CurrentSince Sep 15, 2009 Accepting new patients
Mark a Lazar DPM PC Foot & Ankle Surgery Past Accepting new patients
Major Hospital Past Accepting new patients
Cincinnati Foot Clinic Inc. Podiatrist Past Accepting new patients

Locations

275 W Bassett Rd
Shelbyville, IN 46176
Phone (317) 392-2161

30 W Rampart St
Ste 180
Shelbyville, IN 46176
Phone (317) 392-0003

2451 Intelliplex Dr
#210
Shelbyville, IN 46176
Phone (317) 421-1914

30 W Rampart St
Ste 200
Shelbyville, IN 46176
Phone (317) 398-0121

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1962434795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W BASSETT RD",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768574",
            "telephone_number": "317-392-0003",
            "fax_number": "317-392-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W BASSETT RD",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768574",
            "telephone_number": "317-392-0003",
            "fax_number": "317-392-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISHER",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "070001053A",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36.003397",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36.003397",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200890930",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IN

Sources for this page

Verify at the official NPI Registry.