NPIMap

Individual provider Active NPI

Lisa J Nutter, APNP

  • Family Nurse Practitioner
  • La Crescent, MN
National Provider Identifier
1447325170
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R1236242 Issued in MN
Practice address
226 N 2ND St
La Crescent, MN 55947-1111
Phone
(507) 895-6610
NPI assigned
Nov 21, 2006
Last updated
May 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2016

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 R1236242 MN Primary

Addresses

Primary practice location

226 N 2ND St
La Crescent, MN 55947-1111

Mailing address

1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

Other identifiers 1

IdentifierTypeStateIssuer
658023800MedicaidMN

Other names 1

  • Mrs. Lisa Johnson Nutter Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071207000258 MN Practitioner - Nurse Practitioner 5294824702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gundersen Clinic LTDGroup PAC ID 9638082779, 422 clinicians

Practice addresses (Care Compare)

123 SE 5TH Ave
Spring Grove, MN 55974-1318
Phone (507) 498-3302

125 5TH Ave SE
Spring Grove, MN 55974-1318
Phone (507) 498-3211

511 E Maple St
Houston, MN 55943-9219
Phone (507) 896-6000

805 S Main Ave
Harmony, MN 55939-6625
Phone (507) 886-8888

815 Main Ave S
Harmony, MN 55939-6625
Phone (507) 886-6544

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Express Care, Inc CurrentSince Aug 31, 2009 Accepting new patients
Gundersen Clinic LTD CurrentSince Aug 31, 2009 Accepting new patients
Gundersen Lutheran Medical Center, Inc. Past Accepting new patients

Locations

226 N 2nd St
La Crescent, MN 55947
Phone (507) 895-6610

331 S 3rd St
La Crescent, MN 55947
Phone (507) 895-6610

123 5th Ave SE
Spring Grove, MN 55974
Phone (507) 498-3302

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

Interoperability endpoints

  • Direct secure messaging: lnutter15831@direct.emplifyhealth.org

Organizations & group practices 3

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 9

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1447325170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 N 2ND ST",
            "city": "LA CRESCENT",
            "state": "MN",
            "postal_code": "559471111",
            "telephone_number": "507-895-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTTER",
        "first_name": "LISA",
        "middle_name": "J",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R1236242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "658023800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "NUTTER",
            "middle_name": "JOHNSON",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in La Crescent, MN

Sources for this page

Verify at the official NPI Registry.