Individual provider Active NPI

Lisa Moreno-Walton, MD

  • Emergency Medicine Physician
  • Mobile, AL
National Provider Identifier
1184790610
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD.49838 Issued in AL
Practice address
2451 University Hospital Dr
Mobile, AL 36617-2300
Phone
(251) 471-7000
Fax
(251) 471-7096
NPI assigned
Nov 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 191026 NY
Emergency Medicine Physician 207P00000X 2022-02833 NC
Emergency Medicine Physician 207P00000X MD.49838 AL Primary

Addresses

Primary practice location

2451 University Hospital Dr
Mobile, AL 36617-2300

Mailing address

PO Box 746450
Atlanta, GA 30374-6450
Phone (866) 401-3057

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250124003523 AL Practitioner - Emergency Medicine 9436197506 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.49838ALMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
USA Health Physician Billing Services LLC Emergency Medicine CurrentSince Dec 9, 2024 Accepting new patients
USA Health Physician Billing Services LLC CurrentSince Dec 9, 2024 Accepting new patients
Downtown Bronx Medical Associates PC Past Accepting new patients
Lincon Medical and Mental Center Past Accepting new patients
Keith Van Meter & Associates Past Accepting new patients

Locations

75 S University Blvd
Unit 6500
Mobile, AL 36608
Phone (251) 445-8282

75 S University Blvd
Unit 6000
Mobile, AL 36608
Phone (251) 660-5555

2451 University Hospital Dr
Mobile, AL 36617
Phone (251) 471-7000

Organizations & group practices 5

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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1184790610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746450",
            "telephone_number": "866-401-3057",
            "fax_number": "318-868-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 UNIVERSITY HOSPITAL DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366172300",
            "telephone_number": "251-471-7000",
            "fax_number": "251-471-7096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO-WALTON",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "191026",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2022-02833",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "MD.49838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.