Lisa Ma Provera

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

122606 Issued in CT

Practice address

43 Woodland St
Hartford, CT 06105-2363

Phone

(888) 793-3500

NPI assigned

Nov 5, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: lisa.provera.p1@direct.wheelerclinic.nextgenshare.com

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

{
    "created_epoch": "1509840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509840000000",
    "number": "1922510536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 FALKNOR DR",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060402642",
            "telephone_number": "860-961-9558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 WOODLAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052363",
            "telephone_number": "888-793-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVERA",
        "first_name": "LISA",
        "middle_name": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-05",
        "last_updated": "2017-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "122606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norbert Derrek Promagan, MD
• Promed Preferred CT, PC
• Carla Emmanuelle Prophete, PA-C
• Nicole Prouty, APRN
• Kayla Marie Provenzano, MD
• Bryan Thomas Proxee, PA
• Carla M. Pruden, M.D.
• Helen Margaret Psarakis, APRN
• James Psaras, DDS
• Psych Solutions LLC

• Registered Nurse in Hartford, CT
• Providers in Hartford, CT by specialty
• Registered Nurse in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2017; 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.