Lisa Lallier Blackwelder, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN.0992320-NP Issued in CO

Practice address

7610 N Union Blvd Ste 140
Colorado Springs, CO 80920-3894

Phone

(719) 550-1172

Fax

(719) 591-2864

NPI assigned

Nov 20, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Nurse Practitioner

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centura Health-Penrose St Francis Health Services Hospital, Colorado Springs, CO, CCN 060031

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.

• Allinfamilymed

  • Primary Care Clinic/Center
  • Colorado Springs, CO
  • NPI 1275142390

  Family

  Medicare reassignment NPD Authorized official
• True North Health Navigation LLC

  dba Dispatch Health

  • Emergency Medicine Physician
  • Denver, CO
  • NPI 1740622133
  Medicare reassignment NPD
• Healthone Carenow Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Parker, CO
  • NPI 1699371047
  NPD
• Tree Tall Counseling, LLC

  • Clinical Social Worker
  • Colorado Springs, CO
  • NPI 1861961336
  NPD (past)
• Longview Wellness Center Inc

  dba Wellness Pointe

  • Federally Qualified Health Center (FQHC)
  • Longview, TX
  • NPI 1447910542
  NPD (past)

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

• Catholic Health Initiatives Colorado

  dba Penrose Cardiac & Pulmonary Rehab Center

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1801436415
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  dba Penrose Hospital

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1932112125
  Care Compare affiliation

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

{
    "created_epoch": "1227139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1396990164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7610 N UNION BLVD STE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203894",
            "telephone_number": "719-550-1172",
            "fax_number": "719-591-2864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7610 N UNION BLVD STE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203894",
            "telephone_number": "719-550-1172",
            "fax_number": "719-591-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELDER",
        "first_name": "LISA",
        "middle_name": "LALLIER",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-20",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "579092",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "2022011328",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0992320-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY NURSE PRACTITIONER",
            "identifier": "579092",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000191726",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-028",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "7508181567022",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070853903",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tawnia Leorah Blackman
• Rebecca Lynn Blackmon, LPC
• Anthony R Blackmore
• Kristoffer Blackthorn Andersson III, DD
• Kimberly Blackwelder, LCSW
• Daniel Blackwell
• Madison Blackwell
• Chase Blackwood, LPCC
• Lee Joseph Blackwood, DC
• Ethan Blagg, LMT

• Family Nurse Practitioner in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.