Individual provider Active NPI

Lisa M. Kyzer, CRNA

  • Certified Registered Nurse Anesthetist
  • Stuttgart, AR
National Provider Identifier
1922023506
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
C001381 Issued in AR
Practice address
1703 N Buerkle St
Stuttgart, AR 72160-3153
Phone
(501) 202-2093
Fax
(501) 202-6316
NPI assigned
Jul 13, 2006
Last updated
Sep 25, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X C001381 AR Primary

Addresses

Primary practice location

1703 N Buerkle St
Stuttgart, AR 72160-3153

Mailing address

11001 Executive Center Dr
Suite 200
Little Rock, AR 72211-4316
Phone (501) 202-2093

Other identifiers 1

IdentifierTypeStateIssuer
150490701MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180608001782 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951386085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Physician Solutions of North Florida, LLC CurrentSince Jun 11, 2018 Accepting new patients
Anesthesia Physician Solutions of North Florida, LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Anesthesia Physician Solutions of North Florida, LLC CurrentSince Jun 11, 2018 Accepting new patients
Jonesboro Anesthesia Inc Past Accepting new patients
Shaw Anesthesia Services, PA Nurse Anesthetist, Certified Registered Past Accepting new patients
West Tennessee Anesthesia, PC Nurse Anesthetist, Certified Registered PastSince Apr 4, 2011 Accepting new patients
Grey Fox Anesthesia, P.a. Past Accepting new patients
Midstate Medical Services PA PastSince Aug 7, 2012 Accepting new patients

Locations

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

325 Cypress Pkwy
Poinciana, FL 34759
Phone (407) 530-2000

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411603200000",
    "number": "1922023506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR",
            "address_2": "SUITE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114316",
            "telephone_number": "501-202-2093",
            "fax_number": "501-202-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 N BUERKLE ST",
            "city": "STUTTGART",
            "state": "AR",
            "postal_code": "721603153",
            "telephone_number": "501-202-2093",
            "fax_number": "501-202-6316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYZER",
        "first_name": "LISA",
        "middle_name": "M.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2014-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C001381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150490701",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuttgart, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.