Individual provider Active NPI

Lisa Burgin, CNP

  • Family Nurse Practitioner
  • Newark, OH
National Provider Identifier
1063673762
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.17299 Issued in OH
Practice address
1577 Fallsburg Rd NE
Newark, OH 43055-9650
Phone
(740) 644-8251
NPI assigned
Jun 24, 2008
Last updated
Apr 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.17299 OH Primary
Registered Nurse 163W00000X RN318652 OH

Addresses

Primary practice location

1577 Fallsburg Rd NE
Newark, OH 43055-9650

Mailing address

1577 Fallsburg Rd NE
Newark, OH 43055-9650
Phone (740) 349-1844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20151113002273 OH Practitioner - Nurse Practitioner 7214247659 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6001 E Broad St
Columbus, OH 43213-1502
Phone (614) 234-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN318652OHMDRegistered Nurse
APRN.CNP.17299OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Ohio, Professional Corporation CurrentSince Oct 5, 2024 Accepting new patients
The Little Clinic of Ohio LLC Family CurrentSince Nov 3, 2015 Accepting new patients

Locations

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

199 Graceland Blvd
Columbus, OH 43214
Phone (614) 410-2814

6001 E Broad St
Columbus, OH 43213
Phone (614) 224-6420

245 Deo Dr
Newark, OH 43055
Phone (740) 364-7013

Interoperability endpoints

  • Direct secure messaging: lburgin2849161@direct.trinity-health.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1063673762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1577 FALLSBURG RD NE",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430559650",
            "telephone_number": "740-349-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1577 FALLSBURG RD NE",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430559650",
            "telephone_number": "740-644-8251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGIN",
        "first_name": "LISA",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.17299",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN318652",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.