Lisa Paulette Panish

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

APRN2975062 Issued in FL

Practice address

9009 Corporate Lake Dr
Tampa, FL 33634-2367

Phone

(727) 433-0157

NPI assigned

Jan 25, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa Paulette Wilson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Agapee Surgical Associates Inc.

  • Surgery Physician
  • Madison, TN
  • NPI 1891782637
  NPD (past)
• Due West Family Healthcare Inc

  • Family Medicine Physician
  • Madison, TN
  • NPI 1457346702
  NPD (past)
• Optum Care Services Company

  • Family Nurse Practitioner
  • Columbia, MD
  • NPI 1912199415

  Gerontology

  NPD (past)

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1073669172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9009 CORPORATE LAKE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336342367",
            "telephone_number": "727-433-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9009 CORPORATE LAKE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336342367",
            "telephone_number": "727-433-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANISH",
        "first_name": "LISA",
        "middle_name": "PAULETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN2975062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "WILSON",
            "middle_name": "PAULETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vincent Robert Panetta, OD
• Haoming Pang, MD
• Graysen Panganiban
• Cary Panichello, CRNA
• Kate Panico, BCBA
• Eleanor Turingan Panjeton, C.R.N.A.
• Geoffrey Danial Panjeton, M.D.
• Lauren Pankuch, LMHC
• Taylor Panno
• Christine A Pannozzo

• Gerontology Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Gerontology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.