Lisa M. Haik, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11024680 Issued in FL

Practice address

302 E James Lee Blvd
Crestview, FL 32539-2827

Phone

(663) 892-7278

NPI assigned

Feb 17, 2023

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

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

White Sands Integrative Medical IncGroup PAC ID 6406254507, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• White Sands Integrative Medical, Inc.

  • General Practice Physician
  • Fort Walton Beach, FL
  • NPI 1447886916
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1245938372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 E JAMES LEE BLVD",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325392827",
            "telephone_number": "663-892-7278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 E JAMES LEE BLVD",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325392827",
            "telephone_number": "663-892-7278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIK",
        "first_name": "LISA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11024680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Guthrie
• Amber Mullins Gutowski, OTR/L
• Ann Kathryn Gwinnup, M.D.
• Gyndoc, LLC
• H E R O E S Express Inc
• Jacqueline Hakanson, MS, CCC-SLP
• Kathleen A Haley-Seymour, D.M.D.
• Christina Hall, OTR/L
• Janet S Hamby, MD
• Dawn Rochelle Hamula

• Family Nurse Practitioner in Crestview, FL
• Providers in Crestview, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.