LISA M IVY (NPI# 1033103296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033103296 |
| Entity Type | Individual |
| Full Name | LISA M IVY |
| Credential | ANP |
| Practice Address |
7 Shackleford West Blvd Little Rock AR 72211-3714 |
| Practice Telephone | 5016645860 |
| Practice Fax Number | 5016640889 |
| Mailing Telephone | 5016645860 |
| Mailing Fax Number | 5016640889 |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2010-02-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
A01826 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073837670 | Lisa Ivy | Contractor | 450 El Dorado Blvd, # 720, Webster, TX 77598-2317 | 2010-03-25 |
| 1285827493 | Lisa Fratesi Ivy | Speech-Language Pathologist | 206 George Hall, Rebel Drive, University, MS 38677-8800 | 2007-08-21 |
| 1669081188 | Lisa Faye Ivy | Speech-Language Pathologist | 1560 Mayflower Ave, Bronx, NY 10461-5400 | 2020-07-30 |
| Street Address |
7 SHACKLEFORD WEST BLVD |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72211-3714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861485302 | Scott L Beau | Internal Medicine | 7 Shackleford West Blvd, Little Rock, AR 72211 | 2005-08-30 |
| 1801411285 | Allyson D Carroll | Dietitian, Registered | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2020-06-11 |
| 1104476720 | Abigail Grace Connerly | Nurse Practitioner | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2019-09-16 |
| 1013560655 | Angela Denise Cheves | Nurse Practitioner | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2019-07-23 |
| 1922565233 | Crystal E Meziere | Nurse Practitioner | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2019-02-22 |
| 1134685217 | Felicia Mae Johnson | Nurse Practitioner | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2019-02-14 |
| 1588132948 | Lauren Elizabeth Mcbride | Nurse Practitioner | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2018-11-05 |
| 1144705047 | Cassandra Love | Nurse Practitioner | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2018-09-27 |
| 1457832842 | Marissa Boggs | Nurse Practitioner | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2018-08-24 |
| 1568955441 | Jared H Umland | Physician Assistant | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2018-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760004618 | Samantha Lenore Hilborn | Behavior Technician | 1525 Merrill Drive Suite 100, Little Rock, AR 72211 | 2020-05-14 |
| 1003437740 | Centers for Youth and Families, Inc. | Community/Behavioral Health | 1521 Merrill Drive, Suite D220 and E200, Little Rock, AR 72211 | 2020-05-05 |
| 1962040568 | Erica N Taylor | Nurse Practitioner | 11800 Financial Center Parkway, Ste 290, Little Rock, AR 72211 | 2019-12-13 |
| 1568932119 | Katie Jones | Nurse Practitioner | 1children's Way, Little Rock, AR 72211 | 2018-11-27 |
| 1356828651 | Kayleigh King | Dietitian, Registered | 4 Shackleford Plz Ste 209, Little Rock, AR 72211 | 2018-07-19 |
| 1699283838 | Kara Elizabeth Simmons | Physician Assistant | 11215 Hermitage Rd Ste 103, Little Rock, AR 72211 | 2018-01-22 |
| 1194241463 | Wendy Newsam Pllc | Counselor | 1 Innwood Circle, Suite 107, Little Rock, AR 72211 | 2017-08-18 |
| 1861915159 | Sarah Renee Beall | Counselor | 10800 Financial Centre #290, Little Rock, AR 72211 | 2017-07-19 |
| 1457873127 | Restore Hope Counseling Center, Pllc | Counselor | One Innwood Circle, Suite 201, Little Rock, AR 72211 | 2017-07-13 |
| 1447707500 | University of Arkansas for Medical Sciences | Durable Medical Equipment & Medical Supplies | 601 Autumn Road, Little Rock, AR 72211 | 2016-09-07 |
| Find all providers in zip 72211 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528691912 | Rachel Wetherington | Nurse Practitioner | 9501 Baptist Health Dr Ste 500, Little Rock, AR 72205-6225 | 2020-02-13 |
| 1811492242 | Megan Ashley Thomas | Nurse Practitioner | 816 N Polk St, Little Rock, AR 72205-3448 | 2018-03-27 |
| 1669972022 | Kristie Stringer | Nurse Practitioner | 11001 Executive Center Dr Ste 200, Little Rock, AR 72211-4393 | 2018-02-12 |
| 1265892186 | Maeghan E Arnold | Nurse Practitioner | 8901 Carti Way Ste 302, Little Rock, AR 72205-6523 | 2016-03-04 |
| 1891103073 | Deborah Evans | Nurse Practitioner | 5 Saint Vincent Cir Ste 500, Little Rock, AR 72205-5412 | 2014-07-31 |
| 1356683890 | Sarah Y. Floyd | Nurse Practitioner | 19 Hatfield Dr, Little Rock, AR 72209-6127 | 2013-03-22 |
| 1265710958 | Dana Lynn Phillips | Nurse Practitioner | 4301 W. Markham Slot 783, Little Rock, AR 72205-7101 | 2011-07-28 |
| 1609050087 | Nicholas Jay Fazio | Nurse Practitioner | 6119 Midtown Ave Ste 202, Little Rock, AR 72205 | 2007-12-20 |
| 1053593509 | Audra Page Arant | Nurse Practitioner | 4301 W Markham St # 602a, Little Rock, AR 72205-7101 | 2007-11-27 |
| 1366537466 | Melody A Walls | Nurse Practitioner | 9500 Kanis Rd Ste 101, Little Rock, AR 72205-6358 | 2006-10-04 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72211 |
Please comment or provide details below to improve the information on LISA M IVY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.