Individual provider Active NPI

Lisa Carr, NURSE

  • Licensed Practical Nurse
  • Avondale, AZ
National Provider Identifier
1265778211
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP047347 Issued in AZ
Practice address
11905 W Cocopah Cir
Avondale, AZ 85323-6292
Phone
(623) 478-6295
NPI assigned
Dec 19, 2012
Last updated
Dec 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

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 LP047347 AZ Primary

Addresses

Primary practice location

11905 W Cocopah Cir
Avondale, AZ 85323-6292

Mailing address

11864 W Hadley St
Avondale, AZ 85323-9104
Phone (602) 336-1070

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
LP047347AZMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1265778211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11864 W HADLEY ST",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853239104",
            "telephone_number": "602-336-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11905 W COCOPAH CIR",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853236292",
            "telephone_number": "623-478-6295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "LISA",
        "credential": "NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-19",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "LP047347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.