Individual provider Active NPI

Lisa Western, DNP, FNP-C

  • Nurse Practitioner
  • Laramie, WY
National Provider Identifier
1558712414
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
45463 Issued in WY
Practice address
1174 N 22ND St
Laramie, WY 82072-5401
Phone
(307) 766-3313
NPI assigned
Jun 22, 2016
Last updated
Aug 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 45463 WY Primary
Family Nurse Practitioner 363LF0000X 6948805-4405 UT

Addresses

Primary practice location

1174 N 22ND St
Laramie, WY 82072-5401

Mailing address

1174 N 22ND St
Laramie, WY 82072-5401
Phone (307) 766-3313

Other practice location 1

4465 S 900 E
Millcreek, UT 84124-2469
Phone (801) 266-2777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20200805001262 WY Practitioner - Nurse Practitioner 2062700396 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of WyomingGroup PAC ID 4183607054, 40 clinicians

Practice addresses (Care Compare)

2710 Harney St
Laramie, WY 82072-3038
Phone (307) 431-5055

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6948805-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Care United Medical Center of Laramie, LLC CurrentSince Jul 1, 2020 Accepting new patients
University of Wyoming Speech and Hearing Clinic CurrentSince Sep 12, 2022 Accepting new patients
University of Wyoming CurrentSince Sep 12, 2022 Accepting new patients
University of Wyoming Current Accepting new patients

Locations

1919 Central Ave
Cheyenne, WY 82001
Phone (307) 514-9888

1174 N 22nd St
Laramie, WY 82072
Phone (307) 745-3704

2710 Harney St
Ste 202
Laramie, WY 82072
Phone (307) 742-3242

2710 Harney St
Ste 202204
Laramie, WY 82072
Phone (307) 431-5055

3810 E Grand Ave
Laramie, WY 82070
Phone (307) 721-1794

Interoperability endpoints

  • Direct secure messaging: lisa.western.1@30244.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1558712414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 N 22ND ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820725401",
            "telephone_number": "307-766-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 N 22ND ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820725401",
            "telephone_number": "307-766-3313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4465 S 900 E",
            "address_purpose": "LOCATION",
            "city": "Millcreek",
            "state": "UT",
            "postal_code": "841242469",
            "country_code": "US",
            "telephone_number": "801-266-2777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WESTERN",
        "first_name": "LISA",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WY",
            "license": "45463",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "6948805-4405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

Verify at the official NPI Registry.