Individual provider Active NPI

Joanna K Lizak

  • Psychiatric/Mental Health Nurse Practitioner
  • Connersville, IN
National Provider Identifier
1083394712
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71014360A Issued in IN
Practice address
2025 Virginia Ave
Connersville, IN 47331-2971
Phone
(765) 827-8064
NPI assigned
Jul 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 28178390A IN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71014360A IN Primary

Addresses

Primary practice location

2025 Virginia Ave
Connersville, IN 47331-2971

Mailing address

511 W College Corner Rd
Centerville, IN 47330-1167

Other practice location 1

950 N Market St
Liberty, IN 47353-8496
Phone (765) 458-5191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20231201000240 IN Practitioner - Nurse Practitioner 5597113563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neighborhood Health Center, Inc.Group PAC ID 6608139621, 11 clinicians

Practice addresses (Care Compare)

2025 Virginia Ave
Connersville, IN 47331-2971
Phone (765) 827-8064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28178390AINMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Health Center CurrentSince Jan 4, 2024 Accepting new patients
Neighborhood Health Center, Inc. Current Accepting new patients

Locations

2025 Virginia Ave
Connersville, IN 47331
Phone (765) 827-8064

950 N Market St
Liberty, IN 47353
Phone (765) 458-5191

101 S 10th St
Richmond, IN 47374
Phone (765) 965-4299

Interoperability endpoints

  • Direct secure messaging: jlizak343240@reidhealth.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/21036/brand/1/csg/1/fhir/r4

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": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1083394712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 W COLLEGE CORNER RD",
            "city": "CENTERVILLE",
            "state": "IN",
            "postal_code": "473301167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 VIRGINIA AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473312971",
            "telephone_number": "765-827-8064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "950 N Market St",
            "address_purpose": "LOCATION",
            "city": "Liberty",
            "state": "IN",
            "postal_code": "473538496",
            "country_code": "US",
            "telephone_number": "765-458-5191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIZAK",
        "first_name": "JOANNA",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "28178390A",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71014360A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Connersville, IN

Sources for this page

Verify at the official NPI Registry.