Individual provider Active NPI

Lisa Carolin Wilmeth, NP

  • Family Nurse Practitioner
  • Lawton, OK
National Provider Identifier
1578281390
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209852 Issued in OK
Practice address
1202 SW 67TH St
Lawton, OK 73505-7437
Phone
(818) 749-1203
NPI assigned
Aug 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209852 OK Primary

Addresses

Primary practice location

1202 SW 67TH St
Lawton, OK 73505-7437

Mailing address

706 Fillmore St
Wichita Falls, TX 76301-4013
Phone (940) 235-9743

Other names 1

  • Lisa Carolin Henning Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240710003537 TX Practitioner - Nurse Practitioner 3971048331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Practice Associates LLPGroup PAC ID 1658368261, 9 clinicians

Practice addresses (Care Compare)

4206 Call Field Rd
Wichita Falls, TX 76308-2519
Phone (940) 397-5200

Hospital & facility affiliations

  • United Regional Health Care System Hospital, Wichita Falls, TX, CCN 450010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209852OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Associates LLP CurrentSince Jun 1, 2024 Accepting new patients
Planned Parenthood Great Plains Past Accepting new patients
Ann L. Nolen PA Past Accepting new patients
Comprehensive Health of Planned Parenthood Great Plains Past Accepting new patients

Locations

4206 Call Field Rd
Wichita Falls, TX 76308
Phone (940) 397-5200

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1660694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1578281390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 FILLMORE ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014013",
            "telephone_number": "940-235-9743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 SW 67TH ST",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735057437",
            "telephone_number": "818-749-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILMETH",
        "first_name": "LISA",
        "middle_name": "CAROLIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-17",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "209852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "HENNING",
            "middle_name": "CAROLIN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.