Individual provider Active NPI

Lisa Joanne Braun, FNP

  • Nurse Practitioner
  • Bentonville, AR
National Provider Identifier
1770925265
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP145979 Issued in TX
Practice address
3101 SE 14TH St
Bentonville, AR 72712-4900
Phone
(479) 250-1053
Fax
(479) 250-0923
NPI assigned
Jul 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP5087 AZ
Family Nurse Practitioner 363LF0000X 219391 AR
Nurse Practitioner 363L00000X AP145979 TX Primary

Addresses

Primary practice location

3101 SE 14TH St
Bentonville, AR 72712-4900

Mailing address

3101 SE 14TH St
Bentonville, AR 72712-4900
Phone (479) 250-1053

Other practice location 1

12428 W Thunderbird Rd
El Mirage, AZ 85335-3113
Phone (623) 344-6500

Other practice location 2

5414 S Broadway Ave
Tyler, TX 75703-1335
Phone (903) 581-1601

Other practice location 3

3593 E Grande Blvd
Tyler, TX 75707-1400
Phone (903) 839-2585

Other practice location 4

1339 S Broadway St
Sulphur Springs, TX 75482-4895
Phone (903) 951-1001

Other names 1

  • Lisa Couture Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230502001877 TX Practitioner - Nurse Practitioner 4486898988 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians
Mother Frances Hospital Regional Health Care CenterGroup PAC ID 9234025636, 120 clinicians

Practice addresses (Care Compare)

3593 E Grande Blvd
Christus Trinity Clinic
Tyler, TX 75707-1400
Phone (903) 839-2585

5414 S Broadway Ave
Christus Mother Frances Hospital
Tyler, TX 75703-1335
Phone (903) 531-5010

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

800 E Dawson St
Tyler, TX 75701-2036

Hospital & facility affiliations

  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
219391ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Jun 20, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jun 20, 2023 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Jun 20, 2023 Accepting new patients
District Medical Group, Inc Past Accepting new patients
Mother Frances Hospital Past Accepting new patients

Locations

1339 S Broadway St
Sulphur Springs, TX 75482
Phone (903) 951-1000

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

5414 S Broadway Ave
Tyler, TX 75703
Phone (903) 581-1601

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

3593 E Grande Blvd
Tyler, TX 75707
Phone (903) 606-1664

Interoperability endpoints

  • Direct secure messaging: lbraun308514@christushealth.direct-ci.net

Organizations & group practices 5

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": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1770925265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 SE 14TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124900",
            "telephone_number": "479-250-1053",
            "fax_number": "479-250-0923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SE 14TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124900",
            "telephone_number": "479-250-1053",
            "fax_number": "479-250-0923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12428 W Thunderbird Rd",
            "address_purpose": "LOCATION",
            "city": "El Mirage",
            "state": "AZ",
            "postal_code": "853353113",
            "country_code": "US",
            "telephone_number": "623-344-6500",
            "fax_number": "623-344-6501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5414 S Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757031335",
            "country_code": "US",
            "telephone_number": "903-581-1601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3593 E Grande Blvd",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757071400",
            "country_code": "US",
            "telephone_number": "903-839-2585",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1339 S Broadway St",
            "address_purpose": "LOCATION",
            "city": "Sulphur Springs",
            "state": "TX",
            "postal_code": "754824895",
            "country_code": "US",
            "telephone_number": "903-951-1001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAUN",
        "first_name": "LISA",
        "middle_name": "JOANNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP5087",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "219391",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP145979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "COUTURE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.