Individual provider Active NPI

Lisa Ann Lytle, APRN, FNP-BC

  • Family Nurse Practitioner
  • Cross Lanes, WV
National Provider Identifier
1720754542
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
107741 Issued in WV
Practice address
5416 Hillbrook Dr
Cross Lanes, WV 25313-1677
Phone
(304) 206-1635
NPI assigned
Aug 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 107741 WV Primary

Addresses

Primary practice location

5416 Hillbrook Dr
Cross Lanes, WV 25313-1677

Mailing address

5416 Hillbrook Dr
Cross Lanes, WV 25313-1677
Phone (304) 206-1635

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20220919003335 WV Practitioner - Nurse Practitioner 6709261258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
JC Edwards School of Medicine, Marshall University, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

830 Pennsylvania Ave
Charleston, WV 25302-3389

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107741WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Aug 24, 2022 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Aug 24, 2022 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

800 Pennsylvania Ave
Charleston, WV 25302
Phone (304) 388-2550

830 Pennsylvania Ave
Ste 103
Charleston, WV 25302
Phone (304) 388-2525

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1720754542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5416 HILLBROOK DR",
            "city": "CROSS LANES",
            "state": "WV",
            "postal_code": "253131677",
            "telephone_number": "304-206-1635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5416 HILLBROOK DR",
            "city": "CROSS LANES",
            "state": "WV",
            "postal_code": "253131677",
            "telephone_number": "304-206-1635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYTLE",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "107741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cross Lanes, WV

Sources for this page

Verify at the official NPI Registry.