Lisa Lauren Antle, APRN/BC/APNP

Primary specialty

Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X

Practice address

3915 N Ridgefield Cir
Shorewood, WI 53211-2451

Phone

(414) 467-4162

Fax

(414) 906-1758

NPI assigned

Aug 13, 2007

Last updated

Aug 13, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI2 enrollments

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Registered Nurse

State licenses

Practice roles

Locations

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.

• Commonheart, Inc.

  dba CommonHeart Home Health

  • Community Based Hospice Care Agency
  • Waukesha, WI
  • NPI 1083652333
  Medicare reassignment NPD
• In Home Medical Group LLC

  • Family Nurse Practitioner
  • Rockford, IL
  • NPI 1497087175

  WI

  Medicare reassignment
• In-Your-Home Medicine & Geriatrics

  • Geriatric Medicine (Internal Medicine) Physician
  • Shorewood, WI
  • NPI 1831200781
  NPD (past)

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1629260716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 N RIDGEFIELD CIR",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112451",
            "telephone_number": "414-467-4162",
            "fax_number": "414-906-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 N RIDGEFIELD CIR",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112451",
            "telephone_number": "414-467-4162",
            "fax_number": "414-906-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTLE",
        "first_name": "LISA",
        "middle_name": "LAUREN",
        "name_prefix": "Ms.",
        "credential": "APRN/BC/APNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "WI",
            "license": null,
            "primary": true
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "WI",
            "license": "2531-033",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Al-Afiyah Integrative Therapy LLC
• Margarette Elaine J Alcesto, OD
• Elizabeth Ann Alesci
• All R Welcome LLC
• Ashley Anne, PHD, LPC
• Lori Arnold, RN
• Sybil Ashworth
• Beau James Banton, D.C.
• Jerolynn Bell-Scaggs, LPC, ADC
• Tracy Ann Bennett, LCSW

• Gerontology Clinical Nurse Specialist in Shorewood, WI
• Providers in Shorewood, WI by specialty
• Gerontology Clinical Nurse Specialist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.