Active NPI
Lisa A Wheeler, PNP
- Pediatric Nurse Practitioner
- Cookeville, TN
National Provider Identifier
1922232131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN79264
- Practice address
- 315 N Washington Ave
Ste 190
Cookeville, TN 38501-5984 - Phone
- (931) 528-3300
- Fax
- (313) 722-1029
- NPI assigned
- May 4, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | RN79264 | TN | Primary |
Addresses
Primary practice location
315 N Washington Ave
Ste 190
Cookeville, TN 38501-5984
Mailing address
315 N Washington Ave
Ste 190
Cookeville, TN 38501-5984
Phone (931) 528-3300
Other practice location 1
435 N Cedar Ave
Cookeville, TN 38501-2422
Phone (931) 526-6100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1517710 | Medicaid | TN | |
| 1512648 | Medicaid | TN | |
| 3001286 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN79264 | TN | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596758400000",
"number": "1922232131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 N WASHINGTON AVE",
"address_2": "STE 190",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385015984",
"telephone_number": "931-528-3300",
"fax_number": "313-722-1029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 N WASHINGTON AVE",
"address_2": "STE 190",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385015984",
"telephone_number": "931-528-3300",
"fax_number": "313-722-1029"
}
],
"practiceLocations": [
{
"address_1": "435 N Cedar Ave",
"address_purpose": "LOCATION",
"city": "Cookeville",
"state": "TN",
"postal_code": "385012422",
"country_code": "US",
"telephone_number": "931-526-6100",
"fax_number": "931-526-6002",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHEELER",
"first_name": "LISA",
"middle_name": "A",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-04",
"last_updated": "2020-08-07",
"certification_date": "2020-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "TN",
"license": "RN79264",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1517710",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1512648",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3001286",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cookeville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.