Active NPI
Lisa Lacross, MS, RD
- Registered Dietitian
- Lapeer, MI
National Provider Identifier
1528843497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86172048
- Practice address
- 865 Whitney Dr
Lapeer, MI 48446-2569 - Phone
- (810) 338-1706
- NPI assigned
- Aug 29, 2023
- Last updated
- Aug 29, 2023
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86172048 | MI | Primary |
Addresses
Primary practice location
865 Whitney Dr
Lapeer, MI 48446-2569
Mailing address
4708 Klam Rd
Columbiaville, MI 48421-9100
Phone (810) 338-1706
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86172048 | MI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693267200000",
"number": "1528843497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4708 KLAM RD",
"city": "COLUMBIAVILLE",
"state": "MI",
"postal_code": "484219100",
"telephone_number": "810-338-1706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "865 WHITNEY DR",
"city": "LAPEER",
"state": "MI",
"postal_code": "484462569",
"telephone_number": "810-338-1706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACROSS",
"first_name": "LISA",
"credential": "MS, RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-29",
"last_updated": "2023-08-29",
"certification_date": "2023-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MI",
"license": "86172048",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lapeer, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.