Individual provider Active NPI

Lisa Enea, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1477330751
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
205381 Issued in AK
Practice address
4020 Folker St
Anchorage, AK 99508-5386
Phone
(907) 563-1000
NPI assigned
Sep 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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 205381 AK Primary

Addresses

Primary practice location

4020 Folker St
Anchorage, AK 99508-5386

Mailing address

4020 Folker St
Anchorage, AK 99508-5386

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20231108002243 AK Practitioner - Nurse Practitioner 3870940109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anchorage Community Mental Health Services IncGroup PAC ID 1052213089, 40 clinicians

Practice addresses (Care Compare)

4020 Folker St
Anchorage, AK 99508-5386
Phone (907) 563-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
205381AKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anchorage Community Mental Health Services, Inc CurrentSince Oct 1, 2023 Accepting new patients
Anchorage Community Mental Health Services Inc. CurrentSince Oct 1, 2023 Accepting new patients

Locations

4045 Lake Otis Pkwy
Ste 209
Anchorage, AK 99508
Phone (907) 561-5440

4020 Folker St
Anchorage, AK 99508
Phone (907) 561-0954

1423 Peger Rd
Fairbanks, AK 99709
Phone (907) 371-1300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1477330751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 FOLKER ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 FOLKER ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085386",
            "telephone_number": "907-563-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENEA",
        "first_name": "LISA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "205381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.