Individual provider Active NPI

Lisa D Prieto, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Crestview, FL
National Provider Identifier
1699453290
Registry record updated Sep 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
05250025 Issued in FL
Practice address
5753 Highway 85 N Ste 7937
Crestview, FL 32536-9365
Phone
(904) 460-4470
NPI assigned
Jul 5, 2023
Last updated
Sep 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2026

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 05250025 FL Primary

Addresses

Primary practice location

5753 Highway 85 N Ste 7937
Crestview, FL 32536-9365

Mailing address

3206 Deerfield Pointe Dr
Orange Park, FL 32073-1900
Phone (904) 460-4470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20250920000712 FL Practitioner - Nurse Practitioner 3779087853 Reassigns benefits to 3 organizations

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
Cimpar Consulting LLCGroup PAC ID 6507052370, 9 clinicians

Practice addresses (Care Compare)

3599 University Blvd S
Jacksonville, FL 32216-4268
Phone (904) 345-7600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05250025FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rhodium Care Group Florida PA CurrentSince Jul 13, 2025 Accepting new patients
Cimpar Consulting, LLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

3599 University Blvd S
Jacksonville, FL 32216
Phone (904) 345-7600

6209 Brooks Bartram Dr
Bldg 100
Jacksonville, FL 32258
Phone (904) 528-3000

101 Madison St
Ste 300
Oak Park, IL 60302
Phone (773) 849-9406

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790380800000",
    "number": "1699453290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3206 DEERFIELD POINTE DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320731900",
            "telephone_number": "904-460-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5753 HIGHWAY 85 N STE 7937",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325369365",
            "telephone_number": "904-460-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIETO",
        "first_name": "LISA",
        "middle_name": "D",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2026-09-26",
        "certification_date": "2026-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "05250025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

Verify at the official NPI Registry.