Lisa Heatly Masterson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

04-30174 Issued in KS

Practice address

550 Pope Ave
Munson Army Health Center Attn:MCXN-Cod,Ms Cotton
Fort Leavenworth, KS 66027-2332

Phone

(913) 684-6562

Fax

(913) 684-6208

NPI assigned

Oct 6, 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

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Shawnee Mission Medical Center

  • Emergency Medical Services (Emergency Medicine) Physician
  • Shawnee Mission, KS
  • NPI 1598970790
  NPD (past)
• Shawnee Mission Medical Center, Inc.

  • Radiology Clinic/Center
  • Roeland Park, KS
  • NPI 1578178521
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962599209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 POPE AVE",
            "address_2": "MUNSON ARMY HEALTH CENTER ATTN:MCXN-COD,MS COTTON",
            "city": "FORT LEAVENWORTH",
            "state": "KS",
            "postal_code": "660272332",
            "telephone_number": "913-684-6562",
            "fax_number": "913-684-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 POPE AVE",
            "address_2": "MUNSON ARMY HEALTH CENTER ATTN:MCXN-COD,MS COTTON",
            "city": "FORT LEAVENWORTH",
            "state": "KS",
            "postal_code": "660272332",
            "telephone_number": "913-684-6562",
            "fax_number": "913-684-6208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERSON",
        "first_name": "LISA",
        "middle_name": "HEATLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-30174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent Mair, RN
• Joshua Adam Mandeville, D.O.
• Joseph Frank Maranto, O.D.
• David Dale Marn, D.C.
• Patricia Lee Mashburn, LCSW, BCD
• Mary C Mathia, RN
• Michael McCaffrie, CHIROPRACTOR
• Myron B. McDaniels, M.D.
• Valerie Lynn McDougall Kestner, MD
• Christine McKnight

• Family Medicine Physician in Fort Leavenworth, KS
• Providers in Fort Leavenworth, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.