Lisa O'Daire, APRN
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Wallingford, KY
NPI 1750009338 · NPPES record last updated Aug 18, 2022
Key facts
- NPI
- 1750009338
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 3017983 (KY)
- Practice address
- 4747 Big Run Rd
Wallingford, KY 41093-8881 - Phone
- (606) 291-8442
- NPI assigned
- Aug 18, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Eventus Ecs, Inc
Extended Care Specialists, Inc
Eventus Wholehealth Midwest Inc
Practice addresses (Care Compare)
306 W Main St
Suite 512
Frankfort, KY 40601-1840
Phone (855) 743-2247
828 Lane Allen Rd
Suite 219
Lexington, KY 40504-3659
Phone (260) 483-9081
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220913003363 | KY | Practitioner - Nurse Practitioner | 1658756572 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3017983 | KY | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eventus Wholehealth Midwest Inc | Current |
Accepting new patients | |
| Extended Care Specialists, Inc | Current |
Accepting new patients | |
| Eventus WH Midwest Care, LLC | Current |
Accepting new patients | |
| Eventus Ecs, Inc | Current |
Accepting new patients | |
| Eventus Ecs - Kentucky, PLLC | Current |
Accepting new patients |
Locations
922 State St
Fl 4
Bowling Green, KY 42101
306 W Main St
Ste 512
Frankfort, KY 40601
Phone (860) 215-2295
828 Lane Allen Rd
Ste 219
Lexington, KY 40504
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 3017983 | KY | Yes |
Addresses
Primary practice location
4747 Big Run Rd
Wallingford, KY 41093-8881
Mailing address
4747 Big Run Rd
Wallingford, KY 41093-8881
Phone (606) 291-8442
Other providers in Wallingford, KY
All providers in Wallingford, KY · Psychiatric/Mental Health Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.