Lisa Rae Woodruff, ANP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

185256 Issued in AK

Practice address

200 Michigan Ave W Ste 103
Battle Creek, MI 49017-3632

Phone

(269) 598-7488

NPI assigned

Jan 9, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Bronson Lakeview Hospital

  • Internal Medicine Physician
  • Paw Paw, MI
  • NPI 1235131137
  Medicare reassignment NPD
• Bronson Lakeview Hospital

  • Rural Health Clinic/Center
  • South Haven, MI
  • NPI 1801538871
  NPD

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1346510252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28284 62ND AVE",
            "city": "LAWTON",
            "state": "MI",
            "postal_code": "490655613",
            "telephone_number": "269-547-7630",
            "fax_number": "269-225-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MICHIGAN AVE W STE 103",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173632",
            "telephone_number": "269-598-7488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "247 S Alaska St",
            "address_purpose": "LOCATION",
            "city": "Palmer",
            "state": "AK",
            "postal_code": "996456335",
            "country_code": "US",
            "telephone_number": "907-600-4444",
            "fax_number": "907-600-4443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "LISA",
        "middle_name": "RAE",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-09",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704253495",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AK",
            "license": "185256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM - BRONSON LAKEVIEW BEHAVIORAL MEDICINE",
            "identifier": "1801818752",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346510252",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Wolfe, DPT
• Kathleen Ann Wolthuis, NP-C
• Women'S Health PC
• Dawn Wood
• Carol Ann Woodmansee, MSN, FNP-C
• Jessica Woods
• Sharon Ann Woodson-Moss, APRN,BC
• Woodward Detroit CVS LLC
• Woodward Detroit CVS LLC
• Madelynn Woolf

• Psychiatric/Mental Health Nurse Practitioner in Battle Creek, MI
• Providers in Battle Creek, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.