Individual provider Active NPI

Lisa Sansalone, P.N.P.

  • Pediatric Nurse Practitioner
  • Houston, TX
National Provider Identifier
1043357908
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
695480 Issued in TX
Practice address
6410 Fannin St
1400
Houston, TX 77030-3000
Phone
(832) 325-7125
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 695480 TX Primary

Addresses

Primary practice location

6410 Fannin St
1400
Houston, TX 77030-3000

Mailing address

PO Box 201088
Houston, TX 77216-1088
Phone (713) 500-3500

Other identifiers 1

IdentifierTypeStateIssuer
8Y1512OtherTXBCBS

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
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
695480TXMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1043357908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 201088",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772161088",
            "telephone_number": "713-500-3500",
            "fax_number": "713-500-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST",
            "address_2": "1400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303000",
            "telephone_number": "832-325-7125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANSALONE",
        "first_name": "LISA",
        "credential": "P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "695480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8Y1512",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.