Lisa Wagner Forrest, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

4301057603 Issued in MI

Practice address

1850 Whites Rd
Kalamazoo, MI 49008-4801

Phone

(269) 343-3900

NPI assigned

Apr 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Bronson Practice Management

  • Internal Medicine Physician
  • Kalamazoo, MI
  • NPI 1104840529
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239667200000",
    "number": "1821051822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2752 CLOYSTER CT",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490082339",
            "telephone_number": "269-492-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 WHITES RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490084801",
            "telephone_number": "269-343-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORREST",
        "first_name": "LISA",
        "middle_name": "WAGNER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2009-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301057603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0C910950",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821051822",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Treasure Ford
• Yasmine Ford
• Clare Elizabeth Foreman, CCC-SLP
• Forensic Fluids Laboratories Inc.
• Dustin M Forney, CRNA
• Autumn Marie Forster
• Andrew Forsyth, M.D.
• Jenna Fort
• Kiara Forte
• Macy Foshee

• Emergency Medicine Physician in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.