Individual provider Active NPI

Lisa Renee Rader, C.N.P.

  • Adult Health Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1053519207
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APN0000019900 Issued in TN
Practice address
7945 Wolf River Blvd
Germantown, TN 38138-1762
Phone
(901) 683-0055
Fax
(901) 685-2969
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APN0000019900 TN Primary

Addresses

Primary practice location

7945 Wolf River Blvd
Germantown, TN 38138-1762

Mailing address

7714 Poplar Ave Ste 200
Attn: Credentialing
Germantown, TN 38138-3941
Phone (901) 322-9080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161104001508 TN Practitioner - Nurse Practitioner 9436346160 Reassigns benefits to 1 organization
I20170322002113 MS Practitioner - Nurse Practitioner 9436346160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The West Clinic P.C.Group PAC ID 2668360579, 115 clinicians

Practice addresses (Care Compare)

1588 Union Ave
Memphis, TN 38104-3729
Phone (901) 300-1562

2001 State Dr
Corinth, MS 38834-9324
Phone (662) 286-3694

240 Grandview Dr
Brighton, TN 38011-4253
Phone (901) 475-0678

7668 Airways Blvd
Southaven, MS 38671-5304
Phone (662) 349-9556

7945 Wolf River Blvd
Germantown, TN 38138-1762
Phone (901) 683-0055

Merit-based Incentive Payment System (MIPS)

Final score
90.15 of 100Reported as subgroup
Quality
83.22
Promoting interoperability
100
Improvement activities
40
Cost
77.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN0000019900TNMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The West Clinic P.C. CurrentSince Sep 4, 2016 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

7668 Airways Blvd
Southaven, MS 38671
Phone (662) 349-9556

7945 Wolf River Blvd
Memphis, TN 38138
Phone (901) 448-7000

100 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 747-1800

7714 Poplar Ave
Ste 200
Memphis, TN 38138
Phone (901) 322-9080

1588 Union Ave
Memphis, TN 38104
Phone (901) 276-2410

Organizations & group practices 2

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1053519207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7714 POPLAR AVE STE 200",
            "address_2": "ATTN: CREDENTIALING",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383941",
            "telephone_number": "901-322-9080",
            "fax_number": "901-922-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7945 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381762",
            "telephone_number": "901-683-0055",
            "fax_number": "901-685-2969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADER",
        "first_name": "LISA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "C.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TN",
            "license": "APN0000019900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.