Lisa Ann Madeya

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP024139 Issued in AZ

Practice address

6330 W Thunderbird Rd
Glendale, AZ 85306-4002

Phone

(623) 412-4603

Fax

(623) 412-4609

NPI assigned

Aug 25, 2016

Last updated

Aug 25, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Peoria Unified School District #11

  • Local Education Agency (LEA)
  • Glendale, AZ
  • NPI 1790807626
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1013462548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064002",
            "telephone_number": "623-412-4603",
            "fax_number": "623-412-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064002",
            "telephone_number": "623-412-4603",
            "fax_number": "623-412-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADEYA",
        "first_name": "LISA",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-25",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "LP024139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "SMITH",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Francis Madden, MD
• Delbert Matthew Maddox, DO
• Toriann Janet Maddux, OT
• Nicole Reis Madera, PA-C
• Ashley Madern, D.M.D.
• Connie Madrid
• Deborah Kay Madrid
• Margarita Madrid, PMHNP-BC
• Dora Madrigal
• Madison Madris, PT

• Licensed Practical Nurse in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Licensed Practical Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.