Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Suzan Olivia Lisenby, MD

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1629572771

Suzan Olivia Lisenby, MD is a Physical Medicine and Rehabilitation in Saint Joseph, Missouri. Graduated from University of Missouri, Kansas City, School of Medicine in 2018, 8 years ago. Practices with Poudre Valley Medical Group LLC, a 2,416-clinician group and accepts Medicare assignment. Licensed in Missouri and Utah.

Years since qualifying
8
Trained at
University of Missouri, Kansas City, School of Medicine
Licensed in
MO, UT
In the registry since
2018
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

101 Mosaic Ct Ste 300
Saint Joseph, MO 64506-0015
Phone: (816) 271-7673
Fax: (816) 271-4924
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence 2022033965 (MO)
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X · Licence 11405437-1205 (UT)

Record details

NPI number1629572771
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 22, 2018
Last updated in NPPESApril 6, 2026
Certification dateApril 6, 2026

Medicare enrollment

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

Medicare specialtyPHYSICAL MEDICINE AND REHABILITATION
Medical schoolUNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE
Graduated 2018 (8 years in practice)
Group practice Poudre Valley Medical Group Llc — 2416 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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