Lisa Marie Park, FNP-BC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

117804 Issued in WV

Practice address

4509 National Rd
Triadelphia, WV 26059-2013

Phone

(304) 639-0873

NPI assigned

Nov 21, 2023

Last updated

Nov 21, 2023By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

WMC Physician Practices LLCGroup PAC ID 0244466753, 112 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Weirton Medical Center, Inc Hospital, Weirton, WV, CCN 510023

Merit-based Incentive Payment System (MIPS)

Final score

70.84 of 100Reported as group

Quality

35.62

Promoting interoperability

96

Improvement activities

40

Cost

70.52

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lpark864078@direct.ahn.org

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.

• WMC Physician Practices LLC

  • Internal Medicine Physician
  • Burgettstown, PA
  • NPI 1518303288

  WV

  Medicare reassignment Care Compare group NPD
• WMC Physician Practices LLC

  • Internal Medicine Physician
  • Weirton, WV
  • NPI 1104280213
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Weirton Medical Center, Inc

  dba Weirton Medial Center

  • General Acute Care Hospital
  • Weirton, WV
  • NPI 1619921947
  Care Compare affiliation

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

{
    "created_epoch": "1700524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1639944382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 285",
            "city": "TRIADELPHIA",
            "state": "WV",
            "postal_code": "260590285",
            "telephone_number": "304-639-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4509 NATIONAL RD",
            "city": "TRIADELPHIA",
            "state": "WV",
            "postal_code": "260592013",
            "telephone_number": "304-639-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-21",
        "last_updated": "2023-11-21",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "117804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Miehle, PHARMD
• Mackenzie Lee Mincey, M.D.
• MKSC Inc. (Marra Knee and Shoulder Center)
• Roger Nicholson
• Lauren Ostapowicz, BA
• Benjamin Arthur Paserba
• Amanda Weishar Patterson, PA-C
• Tania Powell, BS
• Rem Community Options LLC
• Wendy S Rewalt

• Family Medicine Physician in Triadelphia, WV
• Providers in Triadelphia, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.