Individual provider Active NPI

Lisa A Gregg, LPN

  • Licensed Practical Nurse
  • Old Fort, OH
National Provider Identifier
1215230735
Registry record updated Dec 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN-135374-M-IV Issued in OH
Practice address
8072 Fort St.
Old Fort, OH 44861-0078
Phone
(419) 934-0959
NPI assigned
Dec 7, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN-135374-M-IV OH Primary

Addresses

Primary practice location

8072 Fort St.
Old Fort, OH 44861-0078

Mailing address

PO Box 78
Old Fort, OH 44861-0078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN-135374-M-IVOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1291680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291680000000",
    "number": "1215230735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78",
            "city": "OLD FORT",
            "state": "OH",
            "postal_code": "448610078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8072 FORT ST.",
            "city": "OLD FORT",
            "state": "OH",
            "postal_code": "448610078",
            "telephone_number": "419-934-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGG",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-07",
        "last_updated": "2010-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN-135374-M-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Fort, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.