Lisa Renee Henderson, AGNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

57109 Issued in ID

Practice address

415 Sixth St.
Cardiology Department
Lewiston, ID 83501-4255

Phone

(208) 750-7507

Fax

(208) 750-7384

NPI assigned

Oct 26, 2017

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

Medicare fee-for-service enrollment

Enrolled in ID, WA2 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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

PPM Washington LLCGroup PAC ID 0941697569, 7 clinicians

Finding Home Healthcare, Inc.Group PAC ID 7517248537, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elite Home Health Home health agency, Clarkston, WA, CCN 507111

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• PPM Washington LLC

  • Multi-Specialty Clinic/Center
  • Clarkston, WA
  • NPI 1568119204
  Medicare reassignment Care Compare group NPD
• Finding Home Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Eagle, ID
  • NPI 1609327022
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alpowa Healthcare, Inc.

  • Home Health Agency
  • Clarkston, WA
  • NPI 1255672895
  Care Compare affiliation

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1912419243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 6TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012431",
            "telephone_number": "208-750-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 SIXTH ST.",
            "address_2": "CARDIOLOGY DEPARTMENT",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014255",
            "telephone_number": "208-750-7507",
            "fax_number": "208-750-7384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "LISA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-26",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "57109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hillary Elise Hedrick, LMSW
• Bobbi J Heitstuman, PHARM D
• Laura D Heitzman, R.PH.
• Hells Canyon Health and Wellness Pharmacy
• Hells Canyon Health and Wellness Pharmacy
• Esther Henter, AGNP-C
• Kara Jo Herndon, RD
• Andrew Allen Herres Jr., LMP
• Elizabeth Lee Hess-Almubarak, LPC, LMHC
• Lynzee Brooke Hewett, WHNP-BC

• Nurse Practitioner in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.