Lisa Certonio, NNP-BC

Primary specialty

Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X

License

376714-4405 Issued in UT

Practice address

544 S 400 E
St George, UT 84770-3705

Phone

(435) 688-5440

NPI assigned

Mar 6, 2015

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

• Lisa Wilkins Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 21, 2021.

{
    "created_epoch": "1425600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1588057152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2152 S ANGELL HEIGHTS DR",
            "city": "HURRICANE",
            "state": "UT",
            "postal_code": "847372665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 S 400 E",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847703705",
            "telephone_number": "435-688-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERTONIO",
        "first_name": "LISA",
        "credential": "NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-06",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "UT",
            "license": "376714-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lisa.certonio@direct.imail.org",
            "affiliation": "N",
            "address_1": "544 S 400 E",
            "city": "St George",
            "state": "UT",
            "country_code": "US",
            "postal_code": "847703705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "WILKINS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Centerfield Healthcare
• Centerfield Healthcare
• Central Utah Clinic, P.C.
• Central Utah Clinic, P.C.
• Central Utah Clinic, P.C.
• Matthew Certonio, NP
• Alessandra Cervantes
• Rita Rose Cervantes
• Colby Cevering, DO
• Caleb Chacon, PMHNP

• All providers in St George, UT
• Critical Care Neonatal Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.