Individual provider Active NPI

Liza Anna Anton-Valdez, DNP, MSN,NP-C

  • Adult Health Nurse Practitioner
  • Southern Pines, NC
National Provider Identifier
1346658564
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5012110 Issued in NC
Practice address
206 Commerce Ave
Southern Pines, NC 28387-7059
Phone
(201) 383-1949
NPI assigned
Jul 31, 2014
Last updated
Sep 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5012110 NC
Adult Health Nurse Practitioner 363LA2200X 26NJ00511600 NJ
Adult Health Nurse Practitioner 363LA2200X 5012110 NC Primary

Addresses

Primary practice location

206 Commerce Ave
Southern Pines, NC 28387-7059

Mailing address

10 Lake Hills Rd
Pinehurst, NC 28374-9639
Phone (910) 724-0182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20200311001356 NC Practitioner - Nurse Practitioner 5395061790 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ih Physician Services PCGroup PAC ID 5991165458, 56 clinicians

Practice addresses (Care Compare)

100 Pavilion Way
Suite E4 and E5
Southern Pines, NC 28387-4559
Phone (910) 684-5078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5012110NCMDAdult Health Nurse Practitioner
26NJ00511600NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physiatry Consultants of NC PLLC CurrentSince Jul 1, 2022 Accepting new patients
Ih Physician Services PC CurrentSince Jun 3, 2023 Accepting new patients
Theoria Medical Nurse Practitioner CurrentSince Jun 13, 2022 Accepting new patients
Ih Physician Services, PC CurrentSince Jun 3, 2023 Accepting new patients
Preferred Network PLLC Adult Health CurrentSince Aug 1, 2020 Accepting new patients

Locations

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

1 Pond St
Arden, NC 28704
Phone 82877452220027

655 Brawley School Rd
Ste 200
Mooresville, NC 28117

430 W Health Center Dr
Nags Head, NC 27959
Phone (252) 441-3116

2702 Farrell Rd
Sanford, NC 27330
Phone (919) 608-9123

206 Commerce Ave
Southern Pines, NC 28387
Phone (201) 383-1949

100 Pavilion Way
Ste E4
Southern Pnes, NC 28387
Phone (910) 684-5078

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1346658564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 LAKE HILLS RD",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283749639",
            "telephone_number": "910-724-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 COMMERCE AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283877059",
            "telephone_number": "201-383-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTON-VALDEZ",
        "first_name": "LIZA",
        "middle_name": "ANNA",
        "credential": "DNP, MSN,NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5012110",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00511600",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5012110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southern Pines, NC

Sources for this page

Verify at the official NPI Registry.