Individual provider Active NPI

Lisa Christine Obert, M.D.

  • Vascular & Interventional Radiology Physician
  • Gallipolis, OH
National Provider Identifier
1710183702
Registry record updated Mar 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
35.092337 Issued in OH
Practice address
90 Jackson Pike
Gallipolis, OH 45631-1560
Phone
(740) 446-5697
Fax
(740) 446-5697
NPI assigned
Jun 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 35.092337 OH Primary
Diagnostic Radiology Physician 2085R0202X 35092337 OH
Body Imaging Physician 2085B0100X 35092337 OH

Addresses

Primary practice location

90 Jackson Pike
Gallipolis, OH 45631-1560

Mailing address

1331 N Elm St
Suite 200
Greensboro, NC 27401-6302
Phone (336) 274-9617

Other identifiers 2

IdentifierTypeStateIssuer
0069375MedicaidOH
3810026385MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120824000037 OH Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 0446407522 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of Louisville School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tristate Img (Imaging Medical Group) IncGroup PAC ID 6204732365, 45 clinicians

Practice addresses (Care Compare)

375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 865-1331

Hospital & facility affiliations

  • Bethesda North Hospital, Cincinnati, OH, CCN 360179
  • Good Samaritan Hospital Hospital, Cincinnati, OH, CCN 360134
  • McCullough-Hyde Memorial Hospital Hospital, Oxford, OH, CCN 360046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25611WVMDLicensed Practical Nurse
35092337OHMDBody Imaging Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tristate Img (Imaging Medical Group) Inc CurrentSince Feb 1, 2022 Accepting new patients
Columbus Radiology Corp Diagnostic Radiology CurrentSince Sep 1, 2015 Accepting new patients

Locations

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

379 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-1400

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

107 Royal Birkdale Dr
Ste A
Columbiana, OH 44408
Phone (330) 482-9350

111 S Grant Ave
Columbus, OH 43215
Phone (614) 461-3232

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

1400 E 2nd St
Defiance, OH 43512
Phone (419) 784-1414

1932 Niles Cortland Rd NE
Ste P
Warren, OH 44484
Phone (330) 856-7702

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457308800000",
    "number": "1710183702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 N ELM ST",
            "address_2": "SUITE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274016302",
            "telephone_number": "336-274-9617",
            "fax_number": "336-482-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-446-5697",
            "fax_number": "740-446-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERT",
        "first_name": "LISA",
        "middle_name": "CHRISTINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2016-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OH",
            "license": "35.092337",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35092337",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "OH",
            "license": "35092337",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0069375",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810026385",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallipolis, OH

Sources for this page

Verify at the official NPI Registry.