Organization Active NPI

Lisa Whims-Squires, D.O., PA

  • Pulmonary Disease Physician
  • Clearwater, FL
National Provider Identifier
1477592426
Registry record updated Jan 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
OS6918 Issued in FL
Legal business name
LISA WHIMS-SQUIRES, D.O., PA
Practice address
1305 S Fort Harrison Ave
BLDG. G
Clearwater, FL 33756-3301
Phone
(727) 466-9847
Fax
(727) 466-0346
NPI assigned
Jun 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2010

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

Authorized official

Name
Dr. Lisa A Whims-Squires, D.O.NPI 1831133446
Title
P.a.
Phone
(727) 466-9847

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X OS6918 FL Primary

Addresses

Primary practice location

1305 S Fort Harrison Ave
BLDG. G
Clearwater, FL 33756-3301

Mailing address

2840 W Bay Dr
Suite 273
Belleair Bluffs, FL 33770-2620
Phone (727) 466-9847

Other identifiers 9

IdentifierTypeStateIssuer
110241957OtherFLRRMEDICARE
UNITED HEALTHOtherFL4885700
259527OtherFLAVMED
FIRST HEALTHOtherFL1745733
256024100MedicaidFL
3617741OtherFLCIGNA
AMERIGROUPOtherFL223693
2799257OtherFLAETNA
44392OtherFLBC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060809000169 FL Part B Supplier - Clinic/Group Practice 3971506130 Receives reassigned benefits from 1 practitioner
Practice locations: Clearwater, FL

National Provider Directory

National Provider Directory

Locations

1305 S Fort Harrison Ave
Ste A
Clearwater, FL 33756
Phone (727) 461-4600

1305 S Fort Harrison Ave
Ste G
Clearwater, FL 33756
Phone (727) 446-0600

1305 S Fort Harrison Ave
Clearwater, FL 33756
Phone (727) 446-0600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262736000000",
    "number": "1477592426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 W BAY DR",
            "address_2": "SUITE 273",
            "city": "BELLEAIR BLUFFS",
            "state": "FL",
            "postal_code": "337702620",
            "telephone_number": "727-466-9847",
            "fax_number": "727-466-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 S FORT HARRISON AVE",
            "address_2": "BLDG. G",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563301",
            "telephone_number": "727-466-9847",
            "fax_number": "727-466-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA WHIMS-SQUIRES, D.O., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-05",
        "last_updated": "2010-01-06",
        "status": "A",
        "authorized_official_last_name": "WHIMS-SQUIRES",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "P.A.",
        "authorized_official_telephone_number": "727-466-9847",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "OS6918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDICARE",
            "identifier": "110241957",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "4885700",
            "identifier": "UNITED HEALTH",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "259527",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1745733",
            "identifier": "FIRST HEALTH",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256024100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3617741",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "223693",
            "identifier": "AMERIGROUP",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2799257",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "44392",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.