Individual provider Active NPI

Lisa Renee Dickey, APRN, FNP-C

  • Family Nurse Practitioner
  • Gulf Shores, AL
National Provider Identifier
1790316115
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-203666 Issued in AL
Practice address
101 E 15TH Ave
Gulf Shores, AL 36542-3501
Phone
(251) 967-7816
Fax
(251) 967-7832
NPI assigned
Feb 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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 23609 TN
Family Nurse Practitioner 363LF0000X 1-203666 AL Primary

Addresses

Primary practice location

101 E 15TH Ave
Gulf Shores, AL 36542-3501

Mailing address

PO Box 689022
Franklin, TN 37068-9022
Phone (615) 465-7390

Other practice location 1

222 E Dave Ward Dr
Conway, AR 72032-7120
Phone (501) 505-8400

Other practice location 2

32 S Broadview St
Greenbrier, AR 72058-9601
Phone (501) 456-4001

Other practice location 3

PO Box 689022
Franklin, TN 37068-9022
Phone (615) 465-7390

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220719001060 AR Practitioner - Nurse Practitioner 2567883986 Reassigns benefits to 2 organizations
I20250609001871 AL Practitioner - Nurse Practitioner 2567883986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

PO Box
Franklin, TN 37068

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-203666ALMDFamily Nurse Practitioner
23609TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Foley Clinic Corp CurrentSince Jul 1, 2025 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince May 1, 2024 Accepting new patients
Foley Clinic Corp CurrentSince Jul 1, 2025 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince May 1, 2024 Accepting new patients

Locations

161 W Peachtree Ave
Foley, AL 36535
Phone (251) 943-5511

101 E 15th Ave
Gulf Shores, AL 36542
Phone (251) 962-1250

1020 Highway 62 E
Mountain Home, AR 72653
Phone (870) 337-2171

Interoperability endpoints

  • Direct secure messaging: lisa.dickey.1@1599.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/1599/brand/1/csg/341/fhir/r4

Organizations & group practices 6

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": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1790316115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689022",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370689022",
            "telephone_number": "615-465-7390",
            "fax_number": "615-628-6877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E 15TH AVE",
            "city": "GULF SHORES",
            "state": "AL",
            "postal_code": "365423501",
            "telephone_number": "251-967-7816",
            "fax_number": "251-967-7832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 E Dave Ward Dr",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "AR",
            "postal_code": "720327120",
            "country_code": "US",
            "telephone_number": "501-505-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "32 S Broadview St",
            "address_purpose": "LOCATION",
            "city": "Greenbrier",
            "state": "AR",
            "postal_code": "720589601",
            "country_code": "US",
            "telephone_number": "501-456-4001",
            "fax_number": "501-456-4002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "PO Box 689022",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "TN",
            "postal_code": "370689022",
            "country_code": "US",
            "telephone_number": "615-465-7390",
            "fax_number": "615-628-6877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKEY",
        "first_name": "LISA",
        "middle_name": "RENEE",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-04",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "23609",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-203666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "other",
            "affiliation": "N",
            "address_1": "222 E Dave Ward Dr",
            "city": "Conway",
            "state": "AR",
            "country_code": "US",
            "postal_code": "720327120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gulf Shores, AL

Sources for this page

Verify at the official NPI Registry.