Individual provider Active NPI

Lisa Paige Sanders, DNP/FNP

  • Family Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1124161849
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
887049 Issued in MS
Practice address
4381 S Eason Blvd Ste 301
Tupelo, MS 38801-6584
Phone
(662) 377-3008
NPI assigned
Feb 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 887049 MS Primary

Addresses

Primary practice location

4381 S Eason Blvd Ste 301
Tupelo, MS 38801-6584

Mailing address

808 Varsity Dr
Tupelo, MS 38801-4613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20110323000506 MS Practitioner - Nurse Practitioner 5294827077 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

408 Council Cir
Suite B
Tupelo, MS 38801-4949
Phone (662) 377-3008

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
887049MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Clinics Inc Family CurrentSince Apr 1, 2012 Accepting new patients
North Mississippi Medical Clinics Inc CurrentSince Apr 1, 2012 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medical Center Inc. CurrentSince Jul 25, 2022 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Jul 25, 2022 Accepting new patients
Amory Surgery Clinic, PLLC Past Accepting new patients
W Thomas Oakes Jr, MD, PC Past Accepting new patients

Locations

808 Varsity Dr
Tupelo, MS 38801
Phone (662) 377-2386

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

4381 S Eason Blvd
Ste 301
Tupelo, MS 38801
Phone (662) 377-3008

845 S Madison St
Tupelo, MS 38801
Phone (601) 790-5025

408 Council Cir
Ste B
Tupelo, MS 38801
Phone (662) 377-3008

Interoperability endpoints

  • Direct secure messaging: lisasanders@nmhs.medalliesdirect.net

Organizations & group practices 8

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.

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1124161849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 VARSITY DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4381 S EASON BLVD STE 301",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016584",
            "telephone_number": "662-377-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "LISA",
        "middle_name": "PAIGE",
        "credential": "DNP/FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "887049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.