Individual provider Active NPI

Lisa Marie Wright, PA

  • Physician Assistant
  • Limon, CO
National Provider Identifier
1740580539
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3018 Issued in CO
Practice address
820 1St Street
Limon, CO 80828-1120
Phone
(719) 775-2367
Fax
(719) 775-2365
NPI assigned
Oct 26, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3018 CO Primary

Addresses

Primary practice location

820 1St Street
Limon, CO 80828-1120

Mailing address

414 Plymouth NE
Grand Rapids, MI 49505-6038
Phone (616) 454-3465

Other identifiers 1

IdentifierTypeStateIssuer
3018OtherCOMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20141230000917 MI Practitioner - Physician Assistant 3274720784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wayne State University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Metropolitan HospitalGroup PAC ID 5597651836, 421 clinicians

Practice addresses (Care Compare)

2093 Health Dr SW
Wyoming, MI 49519-9691

4055 Cascade Rd SE
Grand Rapids, MI 49546-2149

5900 Byron Ctr Ave
Wyoming, MI 49519-9606

5900 Byron Ctr Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-3243

5900 Byron Ctr Swave
Wyoming, MI 49519-9606
Phone (616) 252-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3018COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital CurrentSince Feb 1, 2020 Accepting new patients
Metropolitan Hospital Past Accepting new patients
Great Lakes Neurosurgical Associates, PC PastSince Mar 11, 2025 Accepting new patients

Locations

4055 Cascade Rd SE
Grand Rapids, MI 49546
Phone (616) 252-4410

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

5950 Metro Way SW
Wyoming, MI 49519
Phone (616) 252-8100

2093 Health Dr SW
Ste 301
Wyoming, MI 49519
Phone (616) 241-3500

Interoperability endpoints

  • Direct secure messaging: lwright60665@direct.metrohealth.net

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.

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": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1740580539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 PLYMOUTH NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495056038",
            "telephone_number": "616-454-3465",
            "fax_number": "616-242-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 1ST STREET",
            "city": "LIMON",
            "state": "CO",
            "postal_code": "808281120",
            "telephone_number": "719-775-2367",
            "fax_number": "719-775-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-26",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "3018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "3018",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Limon, CO

Sources for this page

Verify at the official NPI Registry.