Individual provider Active NPI

Lisa Kristine Mizeur, FNP

  • Family Nurse Practitioner
  • Bend, OR
National Provider Identifier
1003455742
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202100982NP-PP Issued in OR
Practice address
2600 NE Neff Rd
Bend, OR 97701-6337
Phone
(541) 706-4800
Fax
(541) 706-4806
NPI assigned
Dec 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 95013410 CA
Family Nurse Practitioner 363LF0000X 202100982NP-PP OR Primary

Addresses

Primary practice location

2600 NE Neff Rd
Bend, OR 97701-6337

Mailing address

5100 Golden Hill Dr
Weed, CA 96094-9644
Phone (530) 356-5342

Other practice location 1

16337 Everhart Dr
Weed, CA 96094-9400
Phone (530) 938-2297

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lmizeur158616@secure.stcharleshealthcare.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220714000834 OR Practitioner - Nurse Practitioner 8628406873 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians
St Charles Health System IncGroup PAC ID 3870402852, shared by 10 NPIs, 174 clinicians

Practice addresses (Care Compare)

211 NW Larch Ave
Family Care
Redmond, OR 97756-1357
Phone (541) 548-2164

2600 NE Neff Rd
SCMG Imaging
Bend, OR 97701-6337
Phone (541) 706-4905

384 SE Combs Flat Rd
Prineville, OR 97754-2562
Phone (541) 706-2768

51781 Huntington Rd
La Pine, OR 97739-1118
Phone (541) 666-7920

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95013410CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. CurrentSince May 20, 2024 Accepting new patients
St. Charles Health System, Inc. CurrentSince May 20, 2024 Accepting new patients
St. Charles Health System, Inc. Current Accepting new patients
St. Charles Health System, Inc. Family Medicine CurrentSince Aug 29, 2022 Accepting new patients
St. Charles Health System, Inc. CurrentSince Aug 29, 2022 Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

61250 SE Coombs Pl
Bend, OR 97702
Phone (541) 706-5930

2600 NE Neff Rd
Bend, OR 97701
Phone (541) 706-3700

51781 Huntington Rd
La Pine, OR 97739
Phone (541) 666-7920

384 SE Combs Flat Rd
Prineville, OR 97754
Phone (541) 383-3668

384 SE Combs Flat Rd
Ste 1200
Prineville, OR 97754
Phone (541) 447-6263

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

Interoperability endpoints

  • Direct secure messaging: lmizeur158616@secure.stcharleshealthcare.org

Organizations & group practices 8

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 4

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": "1577491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1003455742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 GOLDEN HILL DR",
            "city": "WEED",
            "state": "CA",
            "postal_code": "960949644",
            "telephone_number": "530-356-5342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 NE NEFF RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016337",
            "telephone_number": "541-706-4800",
            "fax_number": "541-706-4806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16337 Everhart Dr",
            "address_purpose": "LOCATION",
            "city": "Weed",
            "state": "CA",
            "postal_code": "960949400",
            "country_code": "US",
            "telephone_number": "530-938-2297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIZEUR",
        "first_name": "LISA",
        "middle_name": "KRISTINE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-28",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "95013410",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202100982NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmizeur158616@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "2600 NE Neff Rd",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977016337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.