Individual provider Active NPI

Lisa Marie Neuenfeldt, APRN

  • Family Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1619290673
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9185753 Issued in FL
Practice address
2100 State Ave
Panama City, FL 32405-4587
Phone
(850) 763-0036
Fax
(850) 763-0259
NPI assigned
Mar 4, 2010
Last updated
Feb 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Clinical Nurse Specialist 364SX0200X ARNP9185753 FL
Adult Health Nurse Practitioner 363LA2200X ARNP9185753 FL
Family Nurse Practitioner 363LF0000X APRN9185753 FL Primary

Addresses

Primary practice location

2100 State Ave
Panama City, FL 32405-4587

Mailing address

2422 Breezy LN
Panama City, FL 32405-3917
Phone (850) 258-7340

Other practice location 1

60 Memorial Medical Pkwy
Palm Coast, FL 32164-5980
Phone (386) 586-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110609000790 FL Practitioner - Nurse Practitioner 7911184411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ocala Oncology Center PLGroup PAC ID 6901950856, 23 clinicians

Practice addresses (Care Compare)

2100 State Ave
Panama City, FL 32405-4587
Phone (850) 763-0036

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9185753FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ocala Oncology Center, PL CurrentSince Jul 1, 2019 Accepting new patients
Ocala Oncology Center PL Family CurrentSince Jul 1, 2019 Accepting new patients
Florida Hospital Physician Group Inc Family Past Accepting new patients

Locations

13940 N US Highway 441
Ste 203
Lady Lake, FL 32159
Phone (352) 259-8940

2100 State Ave
Panama City, FL 32405
Phone (850) 763-0036

2614 Jenks Ave
Panama City, FL 32405
Phone (850) 215-3000

Interoperability endpoints

  • Direct secure messaging: lisa.neuenfeldt@fca.ikm.direct-ci.com

Organizations & group practices 3

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 3

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": "1267660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1619290673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 BREEZY LN",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053917",
            "telephone_number": "850-258-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 STATE AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054587",
            "telephone_number": "850-763-0036",
            "fax_number": "850-763-0259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Memorial Medical Pkwy",
            "address_purpose": "LOCATION",
            "city": "Palm Coast",
            "state": "FL",
            "postal_code": "321645980",
            "country_code": "US",
            "telephone_number": "386-586-2000",
            "fax_number": "317-705-5047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEUENFELDT",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-04",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SX0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Oncology",
            "state": "FL",
            "license": "ARNP9185753",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9185753",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9185753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.