Individual provider Active NPI

Lisa B Neal, ARNP

  • Nurse Practitioner
  • Olympia, WA
National Provider Identifier
1407014749
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP 60662300 Issued in WA
Practice address
413 Lilly Rd NE
Olympia, WA 98506-5133
Phone
(360) 486-6147
Fax
(360) 486-6447
NPI assigned
May 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X RN00127782 WA
Nurse Practitioner 363L00000X AP 60662300 WA Primary

Addresses

Primary practice location

413 Lilly Rd NE
Olympia, WA 98506-5133

Mailing address

PO Box 3505
Portland, OR 97208-3505

Other practice location 1

2830 Madrona Beach Rd NW
Olympia, WA 98502-8865
Phone (360) 280-9054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20171221002374 WA Practitioner - Nurse Practitioner 5698033538 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services WashingtonGroup PAC ID 7719873496, 14 clinicians

Practice addresses (Care Compare)

413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (360) 491-9480

Hospital & facility affiliations

  • Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN00127782WAMDRegistered Nurse First Assistant
AP 60662300WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Physician Assistants LLC CurrentSince Oct 28, 2017 Accepting new patients
Providence Health & Services Washington CurrentSince Nov 28, 2017 Accepting new patients
Providence Health & Services Washington Current Accepting new patients
Providence Health & Services Washington CurrentSince Nov 28, 2017 Accepting new patients
Providence Health & Services Washington Past Accepting new patients

Locations

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

Interoperability endpoints

  • Direct secure messaging: lneal839780@wm.providencedirect.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513641600000",
    "number": "1407014749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3505",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065133",
            "telephone_number": "360-486-6147",
            "fax_number": "360-486-6447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2830 Madrona Beach Rd NW",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985028865",
            "country_code": "US",
            "telephone_number": "360-280-9054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEAL",
        "first_name": "LISA",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-22",
        "last_updated": "2017-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "WA",
            "license": "RN00127782",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP 60662300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.