Lakeisha Colter, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5716 Issued in AZ

Practice address

1108 W Indian School Rd
Ste B
Phoenix, AZ 85013-3107

Phone

(602) 773-5600

Fax

(602) 773-5600

NPI assigned

May 26, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Whispering Palms Medical Inc

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1821314998
  Medicare reassignment
• Del Lago Medical Inc

  • In Home Supportive Care Agency
  • Phoenix, AZ
  • NPI 1568733400
  NPD (past)
• Regenesis Healthcare, Inc

  • Family Medicine Physician
  • Tempe, AZ
  • NPI 1275034183
  NPD (past)

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

{
    "created_epoch": "1401062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1174935100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 W INDIAN SCHOOL RD",
            "address_2": "STE B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133107",
            "telephone_number": "602-773-5600",
            "fax_number": "602-773-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 W INDIAN SCHOOL RD",
            "address_2": "STE B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133107",
            "telephone_number": "602-773-5600",
            "fax_number": "602-773-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLTER",
        "first_name": "LAKEISHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-26",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "5716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "Z177769",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "980599",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Colquitt
• Colt Anesthesia, LLC
• Ayana Mae Colter
• Dion Colter, LIFE COACH
• Joe Colter
• Roshann Renee Colter, APRN
• Ursula Dionne Colter
• Nashalae Colum
• Erin Colvard, RD
• Katherine Tricoles Colville

• Medical Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.