Individual provider Active NPI

Lisa Deshun Smart

  • Family Nurse Practitioner
  • Monroe, LA
National Provider Identifier
1790291342
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP09612 Issued in LA
Practice address
2913 Betin Ave
Monroe, LA 71201-7257
Phone
(318) 388-1250
NPI assigned
Dec 19, 2017
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP09612 LA Primary
Family Medicine Physician 207Q00000X 09612 LA

Addresses

Primary practice location

2913 Betin Ave
Monroe, LA 71201-7257

Mailing address

4 Leslie LN
Monroe, LA 71203-2715
Phone (318) 791-0359

Other practice location 1

4 Leslie Ln
Monroe, LA 71203-2715
Phone (318) 791-0359

Other practice location 2

323 W Walnut Ave
Bastrop, LA 71220-4521
Phone (318) 283-3600

Other identifiers 2

IdentifierTypeStateIssuer
2466186MedicaidLA
AP09612OtherLAAPRN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20180314001969 LA Practitioner - Nurse Practitioner 6406118215 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morehouse General HospitalGroup PAC ID 4284528274, 34 clinicians

Practice addresses (Care Compare)

323 W Walnut Ave
Bastrop, LA 71220-4521
Phone (318) 283-3621

420 S Vine St
Bastrop, LA 71220-4514
Phone (318) 283-3950

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
09612LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Single Specialty CurrentSince Jul 1, 2021 Accepting new patients
Signify Health, LLC Single Specialty CurrentSince Nov 5, 2023 Accepting new patients
Morehouse General Hospital Single Specialty CurrentSince Mar 3, 2025 Accepting new patients
Brfhh Monroe LLC Single Specialty CurrentSince Jan 25, 2021 Accepting new patients
Morehouse General Hospital CurrentSince Mar 3, 2025 Accepting new patients
Primary Health Services Center Past Accepting new patients
Primary Health Services Center Past Accepting new patients

Locations

221 W Hickory Ave
Bastrop, LA 71220
Phone (318) 281-1133

323 W Walnut Ave
Bastrop, LA 71220
Phone (318) 283-3600

532 S Washington St
Bastrop, LA 71220
Phone (318) 281-5600

4864 Jackson St
Monroe, LA 71202
Phone (318) 330-7000

201 Saint Charles Ave
Ste 2500
New Orleans, LA 70170
Phone (504) 582-1416

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: lisa.smart.1@29430.direct.athenahealth.com

Organizations & group practices 8

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 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": "1513641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1790291342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 LESLIE LN",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712032715",
            "telephone_number": "318-791-0359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2913 BETIN AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017257",
            "telephone_number": "318-388-1250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Leslie Ln",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "712032715",
            "country_code": "US",
            "telephone_number": "318-791-0359",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "323 W Walnut Ave",
            "address_purpose": "LOCATION",
            "city": "Bastrop",
            "state": "LA",
            "postal_code": "712204521",
            "country_code": "US",
            "telephone_number": "318-283-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMART",
        "first_name": "LISA",
        "middle_name": "DESHUN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-19",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP09612",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "09612",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2466186",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "AP09612",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.