NPIMap

Individual provider Active NPI

Lisa Anne Knoll, APRN

  • Primary Care Nurse Practitioner
  • West Hartford, CT
National Provider Identifier
1740766500
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
7672 Issued in CT
Practice address
20 Isham Rd
West Hartford, CT 06107-2204
Phone
(860) 527-1669
NPI assigned
Jul 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 7672 CT Primary

Addresses

Primary practice location

20 Isham Rd
West Hartford, CT 06107-2204

Mailing address

20 Isham Rd
West Hartford, CT 06107-2204
Phone (860) 527-1669

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lknoll8003@direct.stfranciscare.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190705000691 CT Practitioner - Nurse Practitioner 0446585988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Connecticut School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prime Healthcare, PCGroup PAC ID 6709787930, 67 clinicians

Practice addresses (Care Compare)

20 Isham Rd
Suite 150B
West Hartford, CT 06107-2204
Phone (860) 522-6118

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7672CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare (Sleep Lab) CurrentSince Sep 1, 2019 Accepting new patients
Prime Healthcare, PC CurrentSince Sep 1, 2019 Accepting new patients

Locations

20 Isham Rd
Ste 150
West Hartford, CT 06107
Phone (860) 522-6118

20 Isham Rd
West Hartford, CT 06107
Phone (860) 527-1669

20 Isham Rd
Ste 150B
West Hartford, CT 06107
Phone (860) 522-6118

30 Jordan Ln
Wethersfield, CT 06109
Phone (860) 263-0253

Interoperability endpoints

  • Direct secure messaging: lisa.knoll.1@31712.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1740766500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 ISHAM RD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072204",
            "telephone_number": "860-527-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 ISHAM RD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072204",
            "telephone_number": "860-527-1669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOLL",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-16",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CT",
            "license": "7672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lknoll8003@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Prime Healthcare Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "20 Isham Rd",
            "city": "West Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061072204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.