Active NPI
Lisa Ann Pentecost, CNP
- Neonatal Nurse Practitioner
- Rapid City, SD
National Provider Identifier
1447373329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- 0137
- Practice address
- 353 Fairmont Blvd
Rapid City, SD 57701-7375 - Phone
- (605) 719-8382
- Fax
- (605) 719-4934
- NPI assigned
- Apr 7, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | 0137 | SD | Primary |
Addresses
Primary practice location
353 Fairmont Blvd
Rapid City, SD 57701-7375
Mailing address
PO Box 3450
Rapid City, SD 57709-3450
Phone (605) 719-8382
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R025334 | Other | SD | RN LICENSE |
| 6829780 | Medicaid | SD | |
| 4993198 | Other | SD | WELLMARK |
| 0137 | Other | SD | CNP LICENSE |
Other names 1
- Lisa Ann Sea
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0137 | SD | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203120000000",
"number": "1447373329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3450",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577093450",
"telephone_number": "605-719-8382",
"fax_number": "605-719-4934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "353 FAIRMONT BLVD",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577017375",
"telephone_number": "605-719-8382",
"fax_number": "605-719-4934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENTECOST",
"first_name": "LISA",
"middle_name": "ANN",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-07",
"last_updated": "2008-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "SD",
"license": "0137",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE",
"identifier": "R025334",
"state": "SD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6829780",
"state": "SD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK",
"identifier": "4993198",
"state": "SD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CNP LICENSE",
"identifier": "0137",
"state": "SD"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LISA",
"last_name": "SEA",
"middle_name": "ANN",
"credential": "CNP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Rapid City, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.