Individual provider Active NPI

Lisa Ann Corwin, RN FNP-C

  • Family Nurse Practitioner
  • Washington, MO
National Provider Identifier
1740479757
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2010022930 Issued in MO
Practice address
901 Patients First Dr
Washington, MO 63090-4700
Phone
(636) 390-5503
Fax
(636) 390-1760
NPI assigned
Oct 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2004016343 MO
Family Nurse Practitioner 363LF0000X 2010022930 MO Primary

Addresses

Primary practice location

901 Patients First Dr
Washington, MO 63090-4700

Mailing address

901 Patients First Dr
Washington, MO 63090-4700
Phone (636) 390-5503

Other identifiers 2

IdentifierTypeStateIssuer
P01134560OtherMORAILROAD MEDICARE
1740479757MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20100928000195 MO Practitioner - Nurse Practitioner 4587780572 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, shared by 6 NPIs, 573 clinicians

Practice addresses (Care Compare)

3637 S Geyer Rd
Saint Louis, MO 63127-1203
Phone (314) 251-4659

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004016343MOMDRegistered Nurse
2010022930MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities CurrentSince Jul 1, 2012 Accepting new patients
Mercy Clinic East Communities Family Current Accepting new patients

Locations

125 N Old Highway 66
Bourbon, MO 65441
Phone (573) 679-2006

9513 Highway 100
New Haven, MO 63068
Phone (573) 237-6100

440 Hometown Plaza Dr
Owensville, MO 65066
Phone (573) 437-6100

1001 Cardwell St
Saint Clair, MO 63077
Phone (636) 629-3300

3637 S Geyer Rd
Saint Louis, MO 63127
Phone (314) 251-4659

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

1326 S Service Rd W
Ste 10
Sullivan, MO 63080
Phone (573) 468-4455

1326 S Service Rd W
Ste 20
Sullivan, MO 63080
Phone (573) 468-3555

97 Saint Andrews Dr
Union, MO 63084
Phone (636) 583-2946

901 Patients First Dr
Washington, MO 63090
Phone (636) 239-7500

901 Patients First Dr
Ste 2742
Washington, MO 63090
Phone (636) 239-8825

851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101

Interoperability endpoints

  • Direct secure messaging: lcorwin76933@directc.mercy.net

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 1

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": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1740479757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 PATIENTS FIRST DR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904700",
            "telephone_number": "636-390-5503",
            "fax_number": "636-390-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 PATIENTS FIRST DR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904700",
            "telephone_number": "636-390-5503",
            "fax_number": "636-390-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORWIN",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-16",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2004016343",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2010022930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01134560",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740479757",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

Verify at the official NPI Registry.