Individual provider Active NPI

Lisa Charlina Willhite, LPN

  • Licensed Practical Nurse
  • Goodyear, AZ
National Provider Identifier
1962692756
Registry record updated Jul 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP028098 Issued in AZ
Practice address
16750 W Garfield St
Goodyear, AZ 85338-6287
Phone
(623) 772-4710
Fax
(623) 772-4720
NPI assigned
Jul 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP028098 AZ Primary

Addresses

Primary practice location

16750 W Garfield St
Goodyear, AZ 85338-6287

Mailing address

16750 W Garfield St
Goodyear, AZ 85338-6287
Phone (623) 772-4710

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LP028098AZMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185494400000",
    "number": "1962692756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16750 W GARFIELD ST",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853386287",
            "telephone_number": "623-772-4710",
            "fax_number": "623-772-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16750 W GARFIELD ST",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853386287",
            "telephone_number": "623-772-4710",
            "fax_number": "623-772-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLHITE",
        "first_name": "LISA",
        "middle_name": "CHARLINA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-27",
        "last_updated": "2007-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "LP028098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; 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.