Lisa M Ivy, ANP
Individual provider Active NPI Acute Care Nurse Practitioner · Little Rock, AR
NPI 1033103296 · NPPES record last updated Feb 16, 2010
Key facts
- NPI
- 1033103296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- A01826 (AR)
- Practice address
- 7 Shackleford West Blvd
Little Rock, AR 72211-3714 - Phone
- (501) 664-5860
- Fax
- (501) 664-0889
- NPI assigned
- Sep 2, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Vanderbilt University School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Arkansas Heart Hospital Rural Health Services, LLC
Arkansas Heart Hospital LLC
Practice addresses (Care Compare)
209 S Portland Ave
Unit 2
Russellville, AR 72801-2339
Phone (501) 664-5860
7 Shackleford W Blvd
Little Rock, AR 72211-3886
Phone (501) 664-5860
Hospital & facility affiliations
- Arkansas Heart Hospital, LLC
- St Marys Regional Medical Center
- Johnson Regional Medical Center
- Chambers Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050318000893 | AR | Practitioner - Nurse Practitioner | 4880645878 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A01826 | AR | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arkansas Heart Hospital, LLC | Current |
Accepting new patients | |
| Arkansas Heart Hospital Rural Health Services, LLC | Current |
Accepting new patients | |
| Arkansas Heart Hospital, LLC | Current |
Accepting new patients |
Locations
7 Shackleford West Blvd
Little Rock, AR 72211
Phone (501) 614-3671
209 S Portland Ave
Unit 2
Russellville, AR 72801
Phone (479) 967-0690
209 S Portland Ave
Russellville, AR 72801
Phone (479) 317-7010
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | A01826 | AR | Yes |
Addresses
Primary practice location
7 Shackleford West Blvd
Little Rock, AR 72211-3714
Mailing address
7 Shackleford West Blvd
Little Rock, AR 72211-3714
Phone (501) 664-5860
Other providers in Little Rock, AR
- Ivory Senior Care & DME Company
- Tynesha Ivory
- William Ivory
- Ivq Little Rock Opco LP
- Karen Elaine Ivy
- Madalyn Ivy
- Vivikta Venkatesh Iyer
- Ferrin Elizabeth Izard
- Ralph Sidney Izard Jr.
- J and R Plus Six Incorporated
All providers in Little Rock, AR · Acute Care Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.