Individual provider Active NPI

Lisa Kristine Butler, MSN, CRNP, FNP-C

  • Family Nurse Practitioner
  • Annapolis, MD
National Provider Identifier
1013650449
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R113046 Issued in MD
Practice address
2002 Medical Pkwy Ste 670
Annapolis, MD 21401-3277
Phone
(443) 481-1150
NPI assigned
Apr 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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 R113046 MD Primary

Addresses

Primary practice location

2002 Medical Pkwy Ste 670
Annapolis, MD 21401-3277

Mailing address

2002 Medical Pkwy Ste 670
Annapolis, MD 21401-3277
Phone (443) 481-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20220823004214 MD Practitioner - Nurse Practitioner 6608259635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

2002 Medical Pkwy
Suite 670
Annapolis, MD 21401-3277
Phone (443) 481-1150

Hospital & facility affiliations

  • Luminis Health Anne Arundel Medical Center, Inc Hospital, Annapolis, MD, CCN 210023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC CurrentSince Aug 1, 2022 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Aug 1, 2022 Accepting new patients

Locations

2002 Medical Pkwy
Ste 670
Annapolis, MD 21401
Phone (410) 481-1150

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

1630 Main St
Ste 213
Chester, MD 21619
Phone (443) 481-5300

Interoperability endpoints

  • Direct secure messaging: lbutler140294@direct.aahs.org

Organizations & group practices 3

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": "1649894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1013650449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY STE 670",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013277",
            "telephone_number": "443-481-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY STE 670",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013277",
            "telephone_number": "443-481-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "LISA",
        "middle_name": "KRISTINE",
        "credential": "MSN, CRNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-14",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R113046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.