Active NPI
Lisa Parke Maier, MD
- Emergency Medicine Physician
- Maryville, IL
National Provider Identifier
1255503587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 036.119597
- Practice address
- 6800 State Route 162
Department of Emergency Medicine
Maryville, IL 62062-8500 - Phone
- (618) 288-5711
- NPI assigned
- Mar 27, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 036.119597 | IL | Primary |
Addresses
Primary practice location
6800 State Route 162
Department of Emergency Medicine
Maryville, IL 62062-8500
Mailing address
6800 State Route 162
Department of Emergency Medicine
Maryville, IL 62062-8500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255503587 | Medicaid | MO | |
| 036119597-3 | Medicaid | IL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.119597 | IL | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311033600000",
"number": "1255503587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 STATE ROUTE 162",
"address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620628500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6800 STATE ROUTE 162",
"address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620628500",
"telephone_number": "618-288-5711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAIER",
"first_name": "LISA",
"middle_name": "PARKE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-27",
"last_updated": "2011-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036.119597",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1255503587",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036119597-3",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maryville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.