Lisa Leilani Van Tine, CPNP,CNS

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APN.0004136-NP Issued in CO

Practice address

3292 Peoria St
Aurora, CO 80010-1517

Phone

(303) 343-6130

Fax

(303) 344-0664

NPI assigned

Aug 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Metro Community Provider Network Inc

  • Federally Qualified Health Center (FQHC)
  • Aurora, CO
  • NPI 1558727883
  Medicare reassignment NPD
• Metro Community Provider Network Inc

  • Federally Qualified Health Center (FQHC)
  • Arvada, CO
  • NPI 1376701300
  NPD
• Metro Community Provider Network, Inc.

  • Community/Retail Pharmacy
  • Aurora, CO
  • NPI 1255591780
  NPD

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1508973074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 S BROADWAY",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133611",
            "telephone_number": "303-761-1977",
            "fax_number": "303-761-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3292 PEORIA ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800101517",
            "telephone_number": "303-343-6130",
            "fax_number": "303-344-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN TINE",
        "first_name": "LISA",
        "middle_name": "LEILANI",
        "credential": "CPNP,CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.0127666",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "RXN.0006301-NP",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "APN.0004136-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Lee Van Meter, MS CCC SLP
• Peter Malcolm Van Os, MD
• Takeshia Van Ross
• Julie Van Saun, PA
• Ethan Hunter Van Sickle
• Cassidy Michaela Van Trease, PHD
• Erin Van Winkle, C-AA
• Hannah Van Wyk
• Kristen Van Wyk, NP
• Jennifer Lee Van

• Pediatric Nurse Practitioner in Aurora, CO
• Providers in Aurora, CO by specialty
• Pediatric Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.