Active NPI
Lisa E Larson Hoyt, APRN-BC
- Gerontology Nurse Practitioner
- Jackson, WY
National Provider Identifier
1013187236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 10367.0054
- Practice address
- 555 East Broadway
220
Jackson, WY 83001-2790 - Phone
- (307) 733-7222
- Fax
- (307) 733-9720
- NPI assigned
- Mar 4, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 10367.0054 | WY | Primary |
| Primary Care Nurse Practitioner | 363LP2300X | 10367.0054 | WY |
Addresses
Primary practice location
555 East Broadway
220
Jackson, WY 83001-2790
Mailing address
PO Box 2257
Idaho Falls, ID 83403-2257
Phone (208) 525-2080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 315839 | Other | WY | BLUE CROSS OF WY |
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10367.0054 | WY | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teton Internal Medicine PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Jackson, WY
- NPI 1649474362
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210032000000",
"number": "1013187236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2257",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834032257",
"telephone_number": "208-525-2080",
"fax_number": "208-525-2662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 EAST BROADWAY",
"address_2": "220",
"city": "JACKSON",
"state": "WY",
"postal_code": "830012790",
"telephone_number": "307-733-7222",
"fax_number": "307-733-9720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON HOYT",
"first_name": "LISA",
"middle_name": "E",
"name_prefix": "Mrs.",
"credential": "APRN-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-04",
"last_updated": "2008-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "WY",
"license": "10367.0054",
"primary": true
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "WY",
"license": "10367.0054",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF WY",
"identifier": "315839",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.