Individual provider Active NPI

Lisa Frances Weaver, NP

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1356587695
Registry record updated May 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13992 Issued in TN
Practice address
1819 W Clinch Ave
Suite 114
Knoxville, TN 37916-2434
Phone
(865) 524-1631
Fax
(865) 541-1727
NPI assigned
Dec 16, 2008
Last updated
May 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 13992 TN Primary

Addresses

Primary practice location

1819 W Clinch Ave
Suite 114
Knoxville, TN 37916-2434

Mailing address

1275 Dick Lonas Rd Unit 101
Knoxville, TN 37909-1383
Phone (865) 584-4747

Other identifiers 1

IdentifierTypeStateIssuer
3714823OtherTNMEDICARE GROUP

Other names 1

  • Lisa Frances Ridenour Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20090608000183 TN Practitioner - Nurse Practitioner 6305996661 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knoxville Kidney Center, PLLCGroup PAC ID 2668485558, 13 clinicians

Practice addresses (Care Compare)

320 Park 40 N Blvd
Suite a
Knoxville, TN 37923-3624
Phone (865) 692-3462

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13992TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, PLLC CurrentSince Apr 30, 2009 Accepting new patients
Knoxville Kidney Center, PLLC CurrentSince Feb 13, 2025 Accepting new patients
Summit Medical Group, PLLC CurrentSince Apr 30, 2009 Accepting new patients
Summit Medical Group PLLC PastSince Mar 24, 2024 Accepting new patients
Summit Medical Group,PLLC Past Accepting new patients

Locations

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

1275 Dick Lonas Rd
Unit 101
Knoxville, TN 37909

1819 Clinch Ave
Ste 114
Knoxville, TN 37916
Phone (865) 524-1631

320 N Park 40 Blvd
#A
Knoxville, TN 37923
Phone (865) 692-3462

Interoperability endpoints

  • Direct secure messaging: lweaver69061@direct.acumenmd.com

Organizations & group practices 5

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": "1229385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1356587695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 DICK LONAS RD UNIT 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091383",
            "telephone_number": "865-584-4747",
            "fax_number": "865-584-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 W CLINCH AVE",
            "address_2": "SUITE 114",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162434",
            "telephone_number": "865-524-1631",
            "fax_number": "865-541-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "LISA",
        "middle_name": "FRANCES",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-16",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "13992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "3714823",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "RIDENOUR",
            "middle_name": "FRANCES",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.