Individual provider Active NPI

Lisa Marie Della Ratta, ARNP-C

  • Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1649203126
Registry record updated Sep 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9180138 Issued in FL
Practice address
1549 Airport Blvd
Pensacola, FL 32504-8633
Phone
(850) 416-4040
Fax
(850) 416-4039
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9180138 FL Primary

Addresses

Primary practice location

1549 Airport Blvd
Pensacola, FL 32504-8633

Mailing address

PO Box 2699
Pensacola, FL 32513-2699
Phone (850) 416-4040

Other names 1

  • Lisa Marie Kocon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9180138FLMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1649203126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-416-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1549 AIRPORT BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048633",
            "telephone_number": "850-416-4040",
            "fax_number": "850-416-4039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELLA RATTA",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "ARNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9180138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "KOCON",
            "middle_name": "MARIE",
            "credential": "ARNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; 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.