Individual provider Active NPI

Lisa Phillips Ward, APN

  • Family Nurse Practitioner
  • Alamo, TN
National Provider Identifier
1053515064
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN7204 Issued in TN
Practice address
18 N Cavalier Dr
Alamo, TN 38001-6468
Phone
(731) 696-4500
Fax
(731) 696-2152
NPI assigned
Jun 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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 APN7204 TN Primary

Addresses

Primary practice location

18 N Cavalier Dr
Alamo, TN 38001-6468

Mailing address

18 N. Cavalier Dr.
Alamo, TN 38001
Phone (731) 696-4500

Other identifiers 1

IdentifierTypeStateIssuer
1510858MedicaidTN

Other names 1

  • Lisa P. Williams Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20081119000487 TN Practitioner - Nurse Practitioner 5395805493

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APN7204TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
BH Services Southeast 1 PC Current Accepting new patients

Locations

18 N Cavalier Dr
Alamo, TN 38001
Phone (731) 696-4500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1053515064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 N. CAVALIER DR.",
            "city": "ALAMO",
            "state": "TN",
            "postal_code": "38001",
            "telephone_number": "731-696-4500",
            "fax_number": "731-696-2152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 N CAVALIER DR",
            "city": "ALAMO",
            "state": "TN",
            "postal_code": "380016468",
            "telephone_number": "731-696-4500",
            "fax_number": "731-696-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "LISA",
        "middle_name": "PHILLIPS",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN7204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1510858",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "WILLIAMS",
            "middle_name": "P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alamo, TN

Sources for this page

Verify at the official NPI Registry.