Lisa S. Rose, FNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

22672.1509 Issued in WY

Practice address

5647 US Highway 26
Dubois, WY 82513-9607

Phone

(307) 455-2516

Fax

(307) 455-2526

NPI assigned

Mar 31, 2016

Last updated

Mar 22, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Community Health Center of Central Wyoming, Inc.

  • Federally Qualified Health Center (FQHC)
  • Casper, WY
  • NPI 1447480561
  Medicare reassignment NPD
• Community Health Center of Central Wyoming Inc

  dba Community Health Center of Central Wyoming Inc Riverton

  • Federally Qualified Health Center (FQHC)
  • Riverton, WY
  • NPI 1275810160
  NPD

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1659734390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 BLACKMORE RD",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826093345",
            "telephone_number": "307-233-6000",
            "fax_number": "307-233-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5647 US HIGHWAY 26",
            "city": "DUBOIS",
            "state": "WY",
            "postal_code": "825139607",
            "telephone_number": "307-455-2516",
            "fax_number": "307-455-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "LISA",
        "middle_name": "S.",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-31",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WY",
            "license": "22672.1509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144824200",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mountain Sage Holistic Clinic, LLC
• North Star Physical Therapy, LLC
• Harry Holmes Oakes-Kroeplin
• Pro Home Health of Wyoming, LLC (PRO Home Health)
• Maureen B Roe, C.M.T.
• Trisha Rose, MSN RN FNP-BC
• Katrina Schueneman, M.S., CCC-SLP
• Whiskey Mountain Dental
• Penelope Wilke, R.N.
• William Lemke Physical Therapy P.C.

• Primary Care Nurse Practitioner in Dubois, WY
• Providers in Dubois, WY by specialty
• Primary Care Nurse Practitioner in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; 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.