Individual provider Active NPI

Lisha Anthony, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1992193239
Registry record updated Jan 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP014645 Issued in PA
Practice address
7407 Stenton Ave
Philadelphia, PA 19150-3709
Phone
(267) 335-5264
Fax
(267) 335-5273
NPI assigned
Jan 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2015

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 SP014645 PA Primary

Addresses

Primary practice location

7407 Stenton Ave
Philadelphia, PA 19150-3709

Mailing address

7407 Stenton Ave
Philadelphia, PA 19150-3709
Phone (267) 335-5264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150430000274 PA Practitioner - Nurse Practitioner 0345569000 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP014645PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Medical Center CurrentSince Feb 16, 2015 Accepting new patients

Locations

208 W Chelten Ave
Philadelphia, PA 19144
Phone (215) 849-3104

7407 Stenton Ave
Philadelphia, PA 19150
Phone (267) 335-5264

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25233/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1420675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420675200000",
    "number": "1992193239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7407 STENTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191503709",
            "telephone_number": "267-335-5264",
            "fax_number": "267-335-5273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7407 STENTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191503709",
            "telephone_number": "267-335-5264",
            "fax_number": "267-335-5273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTHONY",
        "first_name": "LISHA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-08",
        "last_updated": "2015-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP014645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.