Individual provider Active NPI

Lisa Ann Cloutier, ARNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Ocala, FL
National Provider Identifier
1164823332
Registry record updated Jul 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
ARNP9468297 Issued in FL
Practice address
5664 SW 60TH Ave
Ocala, FL 34474
Phone
(352) 291-5555
NPI assigned
Sep 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP9268297 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP9468297 FL Primary
Registered Nurse 163W00000X 056662-21 NH

Addresses

Primary practice location

5664 SW 60TH Ave
Ocala, FL 34474

Mailing address

5664 SW 60TH Ave
Ocala, FL 34474-5677
Phone (352) 291-5555

Other practice location 1

10 Tsienneto Rd
Derry, NH 03038-1505
Phone (606) 434-1577

Other identifiers 1

IdentifierTypeStateIssuer
JD253ZOtherFLMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180104001185 FL Practitioner - Nurse Practitioner 5597021725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

8839 Bryan Dairy Rd
Suite 310
Largo, FL 33777-1207
Phone (239) 223-2751

Merit-based Incentive Payment System (MIPS)

Final score
87.43 of 100Reported as group
Quality
74.02
Promoting interoperability
100
Improvement activities
40
Cost
77.26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
056662-21NHMDRegistered Nurse
ARNP9268297FLMDPsychiatric/Mental Health Nurse Practitioner
ARNP9468297FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dna Comprehensive Therapy Services, LLC CurrentSince Jun 14, 2023 Accepting new patients
Bonita Springs Retirement Village, Inc. CurrentSince Jun 14, 2023 Accepting new patients

Locations

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

7623 Little Rd
Ste 300B
New Port Richey, FL 34654
Phone (727) 910-5990

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

8839 Bryan Dairy Rd
Ste 310
Seminole, FL 33777
Phone (727) 446-5681

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

Interoperability endpoints

  • Direct secure messaging: lisa.cloutier.1@13142.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1164823332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5664 SW 60TH AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344745677",
            "telephone_number": "352-291-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5664 SW 60TH AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "34474",
            "telephone_number": "352-291-5555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Tsienneto Rd",
            "address_purpose": "LOCATION",
            "city": "Derry",
            "state": "NH",
            "postal_code": "030381505",
            "country_code": "US",
            "telephone_number": "606-434-1577",
            "fax_number": "603-434-3101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLOUTIER",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "ARNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP9268297",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP9468297",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NH",
            "license": "056662-21",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "JD253Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.