Individual provider Active NPI

Lisa Danette West, PA-C

  • Medical Physician Assistant
  • Moore, OK
National Provider Identifier
1104896760
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1163 Issued in OK
Practice address
520 S Telephone Rd
Moore, OK 73160-5423
Phone
(405) 793-9355
Fax
(405) 793-1621
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1163 OK Primary

Addresses

Primary practice location

520 S Telephone Rd
Moore, OK 73160-5423

Mailing address

3555 NW 58TH St
Suite 900
Oklahoma City, OK 73112-4707
Phone (405) 917-0418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20040124000070 OK Practitioner - Physician Assistant 9234031733 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Classen Urgent Care Clinic LLCGroup PAC ID 3577737881, 17 clinicians
Classen Family Practice LLCGroup PAC ID 8729215025, 10 clinicians

Practice addresses (Care Compare)

1015 SW 4TH St
Moore, OK 73160-2404
Phone (405) 378-2001

2818 Classen Blvd
Norman, OK 73071-4059
Phone (405) 701-7111

Hospital & facility affiliations

  • Norman Regional Hospital, Norman, OK, CCN 370008
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Classen Family Practice LLC Medical CurrentSince Jan 12, 2021 Accepting new patients
Moore Medical Center, LLC Past Accepting new patients

Locations

1015 SW 4th St
Moore, OK 73160
Phone (405) 378-2001

211 S Main St
Noble, OK 73068
Phone (405) 701-3563

2818 Classen Blvd
Norman, OK 73071
Phone (405) 701-7111

2824 Classen Blvd
#100
Norman, OK 73071
Phone (405) 701-3563

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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.

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104896760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 NW 58TH ST",
            "address_2": "SUITE 900",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124707",
            "telephone_number": "405-917-0418",
            "fax_number": "405-917-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S TELEPHONE RD",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731605423",
            "telephone_number": "405-793-9355",
            "fax_number": "405-793-1621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "LISA",
        "middle_name": "DANETTE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "1163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

Verify at the official NPI Registry.