NPIMap

Individual provider Active NPI

Michael A. Lusk, P.T.

  • Physical Therapist
  • Lucasville, OH
National Provider Identifier
1982686127
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 009744 Issued in OH
Practice address
10098 Bear Creek Rd
Lucasville, OH 45648-9168
Phone
(740) 259-5536
Fax
(740) 259-2531
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 002408 WV
Physical Therapist 225100000X 004114 KY
Physical Therapist 225100000X PT 009744 OH Primary

Addresses

Primary practice location

10098 Bear Creek Rd
Lucasville, OH 45648-9168

Mailing address

2010 Man O War Dr
Raceland, KY 41169
Phone (606) 571-6207

Other identifiers 3

IdentifierTypeStateIssuer
2296082MedicaidOH
7303032000MedicaidKY
7303032000MedicaidWV

Other names 1

  • Michael A. Lusk Professional name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
004114KYMDPhysical Therapist
PT 009744OHMDPhysical Therapist
002408WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lucasville I Facility Operations, LLC Past Accepting new patients
Tandem Health Care of Lucasville I, Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1982686127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 MAN O WAR DR",
            "city": "RACELAND",
            "state": "KY",
            "postal_code": "41169",
            "telephone_number": "606-571-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10098 BEAR CREEK RD",
            "city": "LUCASVILLE",
            "state": "OH",
            "postal_code": "456489168",
            "telephone_number": "740-259-5536",
            "fax_number": "740-259-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSK",
        "first_name": "MICHAEL",
        "middle_name": "A.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "002408",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "004114",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT 009744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2296082",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7303032000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7303032000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "LUSK",
            "middle_name": "A.",
            "credential": "P.T.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lucasville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; 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.