Individual provider Active NPI

Lisa Michele Sample, AG-ACNP

  • Acute Care Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1003582644
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
205023 Issued in OK
Practice address
6161 S Yale Ave
Tulsa, OK 74136-1902
Phone
(918) 494-2200
NPI assigned
Aug 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 205023 OK
Acute Care Nurse Practitioner 363LA2100X 205023 OK Primary

Addresses

Primary practice location

6161 S Yale Ave
Tulsa, OK 74136-1902

Mailing address

6600 S Yale Ave Ste 1400
Tulsa, OK 74136-3331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20220629003282 OK Practitioner - Nurse Practitioner 6608256185 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Care Communications LLCGroup PAC ID 8820136724, 33 clinicians
Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

6161 S Yale Ave
Tulsa, OK 74136-1902

Hospital & facility affiliations

  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
205023OKMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Care Communications LLC CurrentSince Aug 12, 2024 Accepting new patients
Warren Clinic Inc CurrentSince Jun 28, 2022 Accepting new patients

Locations

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

6475 S Yale Ave
Ste 200
Tulsa, OK 74136
Phone (918) 494-4400

6161 S Yale Ave
#A
Tulsa, OK 74136

6600 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-1805

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

Interoperability endpoints

  • Direct secure messaging: lgann24802@direct.saintfrancis.com

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.

Hospital & facility affiliations 2

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": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1003582644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361902",
            "telephone_number": "918-494-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPLE",
        "first_name": "LISA",
        "middle_name": "MICHELE",
        "credential": "AG-ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OK",
            "license": "205023",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "205023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.