Individual provider Active NPI

Lisa Kenyon, RN, APRN-RNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1114762424
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
238019 Issued in AZ
Practice address
4100 S Lindsay Rd Ste 124
Gilbert, AZ 85297-1508
Phone
(480) 256-2643
NPI assigned
Jun 27, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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 Registered Nurse 163WP0808X 238019 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 238019 AZ Primary

Addresses

Primary practice location

4100 S Lindsay Rd Ste 124
Gilbert, AZ 85297-1508

Mailing address

1760 E Pecos Rd Ste 307
Gilbert, AZ 85295-3203
Phone (480) 256-2648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20250326000742 AZ Practitioner - Nurse Practitioner 4880117340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wayfinder Psychiatry and Wellness LLCGroup PAC ID 9335586494, 5 clinicians

Practice addresses (Care Compare)

1760 E Pecos Rd
Suite 231
Gilbert, AZ 85295-3207
Phone (480) 256-2648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Wayfinder Psychiatry and Wellness LLC Psychiatric/Mental Health CurrentSince Mar 17, 2025 Accepting new patients

Locations

1760 E Pecos Rd
Ste 231
Gilbert, AZ 85295
Phone (480) 256-2648

4100 S Lindsay Rd
Ste 124
Gilbert, AZ 85297
Phone (480) 256-2648

1760 E Pecos Rd
Ste 307
Gilbert, AZ 85295
Phone (480) 256-2648

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1114762424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 E PECOS RD STE 307",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852953203",
            "telephone_number": "480-256-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 S LINDSAY RD STE 124",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852971508",
            "telephone_number": "480-256-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENYON",
        "first_name": "LISA",
        "credential": "RN, APRN-RNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-27",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "238019",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "238019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.