Lisa Ann Utsey, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME72026 Issued in FL

Practice address

900 Ingraham Ave
Haines City, FL 33844-4336

Phone

(863) 421-6565

Fax

(863) 421-7474

NPI assigned

Oct 23, 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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lisa.utsey@railroadparkpediatrics.directbygreenway.com

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.

• Daniel R. Renuart, M.D., P.a.

  dba Railroad Park Pediatrics and Four Corners Pediatrics

  • Pediatrics Physician
  • Haines City, FL
  • NPI 1346206935
  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421020800000",
    "number": "1932282803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 INGRAHAM AVE",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338444336",
            "telephone_number": "863-421-6565",
            "fax_number": "863-421-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 INGRAHAM AVE",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338444336",
            "telephone_number": "863-421-6565",
            "fax_number": "863-421-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTSEY",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2015-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME72026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5831637",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE/STAYWELL",
            "identifier": "172406",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "49399",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256001101",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trinity Medical Physicians, LLC (Dr. Lama Medical Center)
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• Mary P. Tyree, P.A.
• United Professional Care LLC
• United Professional Care LLC
• Clonise Valcourt, PHARMD
• Samantha Vanburen, DPT
• Lizbeth Vazquez-Prosper
• Francisco J Vega Garcia, M.D.
• Adriana Vega Rivera

• Pediatrics Physician in Haines City, FL
• Providers in Haines City, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; 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.