Individual provider Active NPI

Lisa E Arnold, NP

  • Nurse Practitioner
  • Carbondale, IL
National Provider Identifier
1376847301
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209008015 Issued in IL
Practice address
1390 Hope Dr
Carbondale, IL 62901-5306
Phone
(618) 351-4972
Fax
(618) 351-6522
NPI assigned
Jan 5, 2011
Last updated
May 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209008015 IL Primary

Addresses

Primary practice location

1390 Hope Dr
Carbondale, IL 62901-5306

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200

Other practice location 1

305 W Jackson St Ste 206
Carbondale, IL 62901-1474
Phone (618) 351-4972

Other names 1

  • Lisa E Nagele Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address larnold13364@sih.direct-ci.com
Direct Messaging Address larnold13364@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20131112000279 IL Practitioner - Nurse Practitioner 7618103151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

305 W Jackson St
Suite 103
Carbondale, IL 62901-1474
Phone (618) 351-4972

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
55.9
Promoting interoperability
100
Improvement activities
40
Cost
72.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209008015ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Medical Services, NFP CurrentSince Oct 14, 2013 Accepting new patients
Southern Illinois Medical Services, NFP PastSince May 1, 2022 Accepting new patients

Locations

1390 Hope Dr
Carbondale, IL 62901
Phone (618) 351-4972

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

305 W Jackson St
Ste 103
Carbondale, IL 62901
Phone 6183514972 ext. 65869

305 W Jackson St
Ste 206
Carbondale, IL 62901
Phone (618) 457-3006

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1294185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1376847301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 HOPE DR",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015306",
            "telephone_number": "618-351-4972",
            "fax_number": "618-351-6522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 W Jackson St Ste 206",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011474",
            "country_code": "US",
            "telephone_number": "618-351-4972",
            "fax_number": "618-457-3078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "LISA",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-05",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209008015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "larnold13364@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "305 W Jackson St Ste 206",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "larnold13364@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "1390 Hope Dr",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629015306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "NAGELE",
            "middle_name": "E",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.