Individual provider Active NPI

Lisa Elmore

  • Day Training/Habilitation Specialist
  • Ellisville, MS
National Provider Identifier
1336074673
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Day Training/Habilitation SpecialistTaxonomy code 373H00000X
License
0741 Issued in MS
Practice address
5192 Highway 11 N
Ellisville, MS 39437-5050
Phone
(601) 649-7921
NPI assigned
Jun 17, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Day Training/Habilitation Specialist 373H00000X 0741 MS Primary

Addresses

Primary practice location

5192 Highway 11 N
Ellisville, MS 39437-5050

Mailing address

PO Box 18679
Hattiesburg, MS 39404-8679
Phone (601) 705-1901

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

NPI Registry JSON

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

{
    "created_epoch": "1781654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1336074673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18679",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394048679",
            "telephone_number": "601-705-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5192 HIGHWAY 11 N",
            "city": "ELLISVILLE",
            "state": "MS",
            "postal_code": "394375050",
            "telephone_number": "601-649-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMORE",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-17",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "MS",
            "license": "0741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellisville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.