Individual provider Active NPI

Lisa Ann Lake, DNP

  • Family Nurse Practitioner
  • West Burlington, IA
National Provider Identifier
1013398023
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A120202 Issued in IA
Practice address
1225 S Gear Ave
Suite 159
West Burlington, IA 52655-1691
Phone
(319) 768-1570
NPI assigned
Jun 16, 2015
Last updated
Aug 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A120202 IA Primary

Addresses

Primary practice location

1225 S Gear Ave
Suite 159
West Burlington, IA 52655-1691

Mailing address

1225 S Gear Ave Ste 159
West Burlington, IA 52655-1686

Other names 1

  • Lisa Thornburg Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20150709002518 IA Practitioner - Nurse Practitioner 2668784299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1221 S Gear Ave
West Burlignton, IA 52655-1679
Phone (319) 768-1000

1225 S Gear Ave
West Burlington, IA 52655-1686

1321 S Gear
West Burlington, IA 52655-1604
Phone (319) 768-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.06 of 100Reported as group
Quality
64.36
Promoting interoperability
81
Improvement activities
40
Cost
75.01

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Iowa Regional Medical Center, Inc. CurrentSince Jul 1, 2021 Accepting new patients

Locations

1201 W Agency Rd
West Burlington, IA 52655
Phone (319) 394-3991

1221 S Gear Ave
West Burlington, IA 52655
Phone (319) 768-3622

1225 S Gear Ave
Ste 159
West Burlington, IA 52655
Phone (319) 752-4553

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1013398023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 S GEAR AVE STE 159",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 S GEAR AVE",
            "address_2": "SUITE 159",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551691",
            "telephone_number": "319-768-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A120202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "THORNBURG",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Burlington, IA

Sources for this page

Verify at the official NPI Registry.