Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Larry G Kisby, PA-C

Individual provider Physician Assistant · NPI 1639127517

Larry G Kisby, PA-C is a Physician Assistant in Fremont, Nebraska. Qualified in 1987, 39 years ago. Practices with Physicians Clinic Inc, a 560-clinician group and accepts Medicare assignment. Licensed in Nebraska.

Years since qualifying
39
Licensed in
NE
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

710 Reynolds Rd
Fremont, NE 68025-2300
Phone: (402) 727-1091
Fax: (402) 727-7628
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 358 (NE)

Record details

NPI number1639127517
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 4, 2006
Last updated in NPPESJuly 10, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1987 (39 years in practice)
Group practice Physicians Clinic Inc — 560 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fremont