Active NPI
Lisa T Cramer, M.D.
- Diagnostic Radiology Physician
- Pueblo, CO
National Provider Identifier
1154377042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 39894
- Practice address
- 1619 N Greenwood St
Suite 103
Pueblo, CO 81003-2644 - Phone
- (719) 542-2167
- Fax
- (719) 542-0320
- NPI assigned
- May 25, 2006
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 39894 | CO | Primary |
| Vascular & Interventional Radiology Physician | 2085R0204X | 39894 | CO |
Addresses
Primary practice location
1619 N Greenwood St
Suite 103
Pueblo, CO 81003-2644
Mailing address
PO Box 11512
Pueblo, CO 81001-0512
Phone (719) 542-2167
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 77659732 | Medicaid | CO |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39894 | CO | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pueblo Imaging Center, LLC | Past | Accepting new patients | |
| Radiology Associates | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 2
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
- Pueblo, CO
- NPI 1497713960
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208390400000",
"number": "1154377042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11512",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810010512",
"telephone_number": "719-542-2167",
"fax_number": "719-542-0320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1619 N GREENWOOD ST",
"address_2": "SUITE 103",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810032644",
"telephone_number": "719-542-2167",
"fax_number": "719-542-0320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAMER",
"first_name": "LISA",
"middle_name": "T",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-25",
"last_updated": "2008-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CO",
"license": "39894",
"primary": true
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "CO",
"license": "39894",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "77659732",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.