Individual provider Active NPI

Lisa A Martin, ARNP

  • Women's Health Nurse Practitioner
  • Brandon, FL
National Provider Identifier
1184612111
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
104299531 Issued in FL
Practice address
515 S Kings Ave Ste 3100
Brandon, FL 33511-6060
Phone
(813) 681-9171
Fax
(813) 681-7580
NPI assigned
Oct 13, 2005
Last updated
Jan 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 104299531 FL Primary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X RN-3215122 FL

Addresses

Primary practice location

515 S Kings Ave Ste 3100
Brandon, FL 33511-6060

Mailing address

PO Box 748817
Atlanta, GA 30374-8817
Phone (813) 286-0333

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
I20050730000195 FL Practitioner - Nurse Practitioner 1355379488 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Care Florida LLCGroup PAC ID 9234031444, 324 clinicians

Practice addresses (Care Compare)

515 S Kings Ave
Suite 3100
Brandon, FL 33511-5921
Phone (813) 681-9171

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104299531FLMDWomen's Health Nurse Practitioner
RN-3215122FLMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Care Florida LLC CurrentSince May 10, 2017 Accepting new patients
Womens' Health Hospitalists, LLC CurrentSince Aug 1, 2016 Accepting new patients
Womens Care Florida LLC PastSince May 1, 2021 Accepting new patients

Locations

515 S Kings Ave
Ste 1100
Brandon, FL 33511
Phone (813) 413-5213

515 S Kings Ave
Ste 3100
Brandon, FL 33511
Phone (813) 681-9171

731 S Parsons Ave
Brandon, FL 33511
Phone (813) 499-1500

13123 Kings Lake Dr
Unit 102
Gibsonton, FL 33534
Phone (813) 574-1350

5470 Lithia Pinecrest Rd
Lithia, FL 33547
Phone (813) 675-9181

2108 Thonotosassa Rd
Plant City, FL 33563
Phone (813) 752-4103

6606 Simmons Loop
Riverview, FL 33578
Phone (813) 574-1350

2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551

4030 W Boy Scout Blvd
Ste 800
Tampa, FL 33607
Phone (813) 286-0333

5002 W Lemon St
Tampa, FL 33609

Organizations & group practices 3

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": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1184612111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748817",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748817",
            "telephone_number": "813-286-0333",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S KINGS AVE STE 3100",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116060",
            "telephone_number": "813-681-9171",
            "fax_number": "813-681-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "104299531",
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "FL",
            "license": "RN-3215122",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.