Lisa L Dalton, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R882967 Issued in MS

Practice address

1855 Lakeland Dr
Ste M20
Jackson, MS 39216-4913

Phone

(601) 364-1132

Fax

(601) 364-1134

NPI assigned

Feb 18, 2013

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

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.

• Enhanced Wellness Living PLLC

  • Nurse Practitioner
  • Jackson, MS
  • NPI 1992161954
  NPD (past)
• Enhanced Wellness, PLLC

  • Clinic/Center
  • Jackson, MS
  • NPI 1811098866
  NPD (past)

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

{
    "created_epoch": "1361145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1104166891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 LAKELAND DR",
            "address_2": "STE M20",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164913",
            "telephone_number": "601-364-1132",
            "fax_number": "601-364-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 LAKELAND DR",
            "address_2": "STE M20",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164913",
            "telephone_number": "601-364-1132",
            "fax_number": "601-364-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALTON",
        "first_name": "LISA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-18",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R882967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Eliese Daley
• Katie Daley, FNP-BC
• Kayla M Daley, COTA/L
• William Patrick Daley, M.D.
• Megan Dallas
• John S Daly, M.D.
• Ahmad Damlaj
• Ashanti Samone Dampier
• Deirdre M Danahar, LICSW
• Mark A Dancy, NP

• All providers in Jackson, MS
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; 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.