Individual provider Active NPI

Lisa Jeanette Speer, APRN

  • Family Nurse Practitioner
  • Conway, AR
National Provider Identifier
1609466473
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
214656 Issued in AR
Practice address
2180 Ada Ave Ste 300
Conway, AR 72034-4300
Phone
(501) 327-6547
Fax
(501) 327-9715
NPI assigned
Jan 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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 214656 AR Primary

Addresses

Primary practice location

2180 Ada Ave Ste 300
Conway, AR 72034-4300

Mailing address

2180 Ada Ave Ste 300
Conway, AR 72034-4300
Phone (501) 327-6547

Other identifiers 1

IdentifierTypeStateIssuer
261975758MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20210210003146 AR Practitioner - Nurse Practitioner 2961817606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conway OB-GYN Clinic PAGroup PAC ID 9931184280, 9 clinicians

Practice addresses (Care Compare)

2180 Ada Ave
Suite 300
Conway, AR 72034-4300
Phone 5013276547101

Hospital & facility affiliations

  • Conway Regional Medical Center, Inc Hospital, Conway, AR, CCN 040029

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
214656ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Conway OB-GYN Clinic PA CurrentSince Oct 28, 2020 Accepting new patients

Locations

2180 Ada Ave
Ste 300
Conway, AR 72034
Phone (501) 327-6547

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1426
  • FHIR API: https://fhir4.healow.com/fhir/r4/CFIBDD
  • Direct secure messaging: lisa.speer@conwayobgyn.eclinicaldirectplus.com

Organizations & group practices 1

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 6

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": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1609466473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 ADA AVE STE 300",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344300",
            "telephone_number": "501-327-6547",
            "fax_number": "501-327-9715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 ADA AVE STE 300",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344300",
            "telephone_number": "501-327-6547",
            "fax_number": "501-327-9715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEER",
        "first_name": "LISA",
        "middle_name": "JEANETTE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "214656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261975758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.