Individual provider Active NPI

Lisa Lashelle Webster

  • Psychiatric/Mental Health Nurse Practitioner
  • Queen Creek, AZ
National Provider Identifier
1104980218
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
318737 Issued in AZ
Practice address
23136 E Camina Buena Vis
Queen Creek, AZ 85142-1327
Phone
(623) 293-1961
NPI assigned
Dec 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X 10122 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 318737 AZ Primary

Addresses

Primary practice location

23136 E Camina Buena Vis
Queen Creek, AZ 85142-1327

Mailing address

23136 E Camina Buena Vis
Queen Creek, AZ 85142-1327
Phone (623) 293-1961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
318737AZMDPsychiatric/Mental Health Nurse Practitioner
10122AZMDChild Intellectual and/or Developmental Disabilities Respite Care

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1104980218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23136 E CAMINA BUENA VIS",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421327",
            "telephone_number": "623-293-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23136 E CAMINA BUENA VIS",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421327",
            "telephone_number": "623-293-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "LISA",
        "middle_name": "LASHELLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "AZ",
            "license": "10122",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "318737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.