Dr Lisa Shives, MD, PC

Primary specialty

Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X

Legal business name

DR LISA SHIVES, MD, PC

Doing business as

Lisa Shives MD Sleep Solutions

Practice address

1853 Lyndon Rd
San Diego, CA 92103-1644

Phone

(773) 914-4961

NPI assigned

Jun 8, 2016

Organization subpart

No

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

Authorized official

Name

Lisa Jo Shives, MDNPI 1740322825

Title

President

Phone

(773) 914-4961

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lisa Shives MD Sleep Solutions Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa Jo Shives, M.D.

  • Sleep Medicine (Internal Medicine) Physician
  • San Diego, CA
  • NPI 1740322825
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1508215773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1853 LYNDON RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921031644",
            "telephone_number": "773-914-4961",
            "fax_number": "847-827-8706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1853 LYNDON RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921031644",
            "telephone_number": "773-914-4961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR LISA SHIVES, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-08",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "SHIVES",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-914-4961",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1740322825",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lisa Shives MD Sleep Solutions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lisa Shives MD Sleep Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Sleep Medicine (Internal Medicine) Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Sleep Medicine (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.