NPIMap

Individual provider Active NPI

Lisa Catherine Doom-Anderson, FNP-BC

  • Family Nurse Practitioner
  • Sioux Falls, SD
National Provider Identifier
1972932374
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP000827 Issued in SD
Practice address
4520 W 69TH St
Sioux Falls, SD 57108-8148
Phone
(605) 977-5000
Fax
(605) 977-5377
NPI assigned
Nov 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CP000827 SD Primary

Addresses

Primary practice location

4520 W 69TH St
Sioux Falls, SD 57108-8148

Mailing address

4520 W 69TH St
Sioux Falls, SD 57108-8148
Phone (605) 977-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, TX, IA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20140122001293 SD Practitioner - Nurse Practitioner 9436387370 Reassigns benefits to 2 organizations
I20140401000340 TX Practitioner - Nurse Practitioner 9436387370 Reassigns benefits to 1 organization
I20170313001135 IA Practitioner - Nurse Practitioner 9436387370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heart Hospital of South Dakota LLCGroup PAC ID 5799777249, 66 clinicians
Avera McKennanGroup PAC ID 0345157103, 957 clinicians
St Michael'S Hospital, Inc.Group PAC ID 2668380262, shared by 6 NPIs, 16 clinicians

Practice addresses (Care Compare)

116 E 10TH St
Suite 101
Spencer, IA 51301-4365
Phone (712) 264-3500

1200 S 7TH Ave
Sioux Falls, SD 57105-0900
Phone (605) 336-2140

410 W 16TH Ave
Tyndall, SD 57066-2318
Phone (605) 589-2158

4500 W 69TH St
Sioux Falls, SD 57108-8148

4520 W 69TH St
Sioux Falls, SD 57108-8148
Phone (605) 977-5000

Hospital & facility affiliations

  • Avera Heart Hospital of South Dakota Hospital, Sioux Falls, SD, CCN 430095
  • Spencer Municipal Hospital Hospital, Spencer, IA, CCN 160112
  • Lakes Regional Healthcare Hospital, Spirit Lake, IA, CCN 160124
  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016
  • Avera St Mary'S Hospital Hospital, Pierre, SD, CCN 430015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan Current Accepting new patients
Avera McKennan CurrentSince Jan 1, 2014 Accepting new patients
Avera McKennan CurrentSince Jan 1, 2014 Accepting new patients
Heart Hospital of South Dakota LLC CurrentSince Jul 1, 2014 Accepting new patients
Heart Hospital of South Dakota LLC Past Accepting new patients

Locations

116 E 11th St
Ste 101
Spencer, IA 51301
Phone (712) 264-3500

4520 W 69th St
Sioux Falls, SD 57108
Phone (605) 977-5000

1910 W 69th St
Sioux Falls, SD 57108
Phone (605) 322-5200

1200 S 7th Ave
Sioux Falls, SD 57105
Phone (605) 336-2140

Interoperability endpoints

  • Direct secure messaging: lisa.doomanderson@avera.sdhealthlink.net

Organizations & group practices 6

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.

Hospital & facility affiliations 32

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1972932374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 W 69TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088148",
            "telephone_number": "605-977-5000",
            "fax_number": "605-977-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 W 69TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088148",
            "telephone_number": "605-977-5000",
            "fax_number": "605-977-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOOM-ANDERSON",
        "first_name": "LISA",
        "middle_name": "CATHERINE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-06",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP000827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.