Active NPI
Lisa Penton Mejia, APRN
- Adult Health Nurse Practitioner
- Bogalusa, LA
National Provider Identifier
1114078839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- AP04640
- Practice address
- 433 Plaza St Ste 38
Bogalusa, LA 70427-3729 - Phone
- (987) 730-2284
- Fax
- (985) 730-2305
- NPI assigned
- Jan 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | AP04640 | LA | |
| Adult Health Nurse Practitioner | 363LA2200X | AP04640 | LA | Primary |
Addresses
Primary practice location
433 Plaza St Ste 38
Bogalusa, LA 70427-3729
Mailing address
5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 526-0018
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457825 | Medicaid | LA |
Other names 1
- Ms. Lisa Penton Herring
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP04640 | LA | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tchefuncte Cardiovascular Associates | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Covington, LA
- NPI 1588645303
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518480000000",
"number": "1114078839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5959 S SHERWOOD FOREST BLVD",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708166038",
"telephone_number": "225-526-0018",
"fax_number": "225-765-9196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "433 PLAZA ST STE 38",
"city": "BOGALUSA",
"state": "LA",
"postal_code": "704273729",
"telephone_number": "987-730-2284",
"fax_number": "985-730-2305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEJIA",
"first_name": "LISA",
"middle_name": "PENTON",
"name_prefix": "Ms.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2018-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "LA",
"license": "AP04640",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "LA",
"license": "AP04640",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1457825",
"state": "LA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LISA",
"last_name": "HERRING",
"middle_name": "PENTON",
"prefix": "MS.",
"credential": "APRN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bogalusa, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.