Individual provider Active NPI

Lisa Kirkton

  • Psychiatric/Mental Health Nurse Practitioner
  • Elkhart, IN
National Provider Identifier
1669920146
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71006510 Issued in IN
Practice address
2600 Oakland Ave
Elkhart, IN 46517-1533
Phone
(574) 533-1234
Fax
(574) 522-5783
NPI assigned
Sep 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71006510 IN Primary

Addresses

Primary practice location

2600 Oakland Ave
Elkhart, IN 46517-1533

Mailing address

10209 Forest Lakes Dr
Middlebury, IN 46540-9413
Phone (574) 238-2503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20161109000804 IN Practitioner - Nurse Practitioner 7618256926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oaklawn Psychiatric Center IncGroup PAC ID 6002801065, 66 clinicians

Practice addresses (Care Compare)

2600 Oakland Ave
Elkhart, IN 46517-1533
Phone (574) 533-1234

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71006510INMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oaklawn Psychiatric Center, Inc. CurrentSince Oct 8, 2016 Accepting new patients
Oaklawn Psychiatric Center, Inc. CurrentSince Oct 8, 2016 Accepting new patients

Locations

2600 Oakland Ave
Elkhart, IN 46517
Phone 5745331234 ext. 488

330 Lakeview Dr
Goshen, IN 46528
Phone (219) 533-1234

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1669920146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10209 FOREST LAKES DR",
            "city": "MIDDLEBURY",
            "state": "IN",
            "postal_code": "465409413",
            "telephone_number": "574-238-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 OAKLAND AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465171533",
            "telephone_number": "574-533-1234",
            "fax_number": "574-522-5783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKTON",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71006510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.