Individual provider Active NPI

Lisa J Thomson, NURSE PRACTITIONER

  • Acute Care Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1184864498
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
COA16504-NP Issued in OH
Practice address
1520 S Main St
Dayton, OH 45409-2698
Phone
(937) 461-5815
NPI assigned
Feb 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN230360 OH
Acute Care Nurse Practitioner 363LA2100X COA16504-NP OH Primary

Addresses

Primary practice location

1520 S Main St
Dayton, OH 45409-2698

Mailing address

1520 S Main St
Dayton, OH 45409-2698
Phone (937) 461-5815

Other names 1

  • Ms. Lisa J Snorf Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150108001501 OH Practitioner - Nurse Practitioner 4385967843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pulmonary and Critical Care Consultants, IncGroup PAC ID 9234115379, 34 clinicians

Practice addresses (Care Compare)

1520 S Main St
Suite 2
Dayton, OH 45409-2643
Phone (937) 461-5815

Hospital & facility affiliations

  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN230360OHMDCritical Care Medicine Registered Nurse
COA16504-NPOHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary & Critical Care Consultants, Inc CurrentSince Nov 8, 2014 Accepting new patients

Locations

1520 S Main St
Ste 2
Dayton, OH 45409
Phone (937) 461-5815

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

1520 S Main St
Dayton, OH 45409
Phone (937) 223-1279

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1235606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1184864498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 S MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092698",
            "telephone_number": "937-461-5815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 S MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092698",
            "telephone_number": "937-461-5815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSON",
        "first_name": "LISA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-26",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "OH",
            "license": "RN230360",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "COA16504-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "SNORF",
            "middle_name": "J",
            "prefix": "MS.",
            "credential": "AGACNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.