LISA SMITH (NPI# 1225118920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225118920 |
| Entity Type | Individual |
| Full Name | LISA SMITH |
| Credential | MPT |
| Practice Address |
2200 Bergquist Dr Ste 1 Attn: Credentials Lackland A F B TX 78236-9908 |
| Mailing Address |
2180 Reese St Bldg 1285 Box 128 Lackland A F B TX 78236-1042 |
| Practice Telephone | 2102925034 |
| Mailing Telephone | 5056933593 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | 1048445 | TX | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124626403 | Lisa Whyeyeh Smith | Early Intervention Provider Agency | 6143 186th St Ste 436, Fresh Meadows, NY 11365-2710 | 2020-10-09 |
| 1982211280 | Lisa Marie Smith | Pharmacist | 5409 S 60th Pl, Rogers, AR 72758-8230 | 2020-09-30 |
| 1710590757 | Lisa M Smith | Occupational Therapy Assistant | 920 Westacre Rd, West Sacramento, CA 95691-3224 | 2020-08-28 |
| 1013531060 | Lisa Marie Smith | Student in an Organized Health Care Education/Training Program | 1465 County Road 232, Collinsville, TX 76233 | 2020-06-05 |
| 1699300350 | Lisa Kathryn Smith | Registered Nurse | 7913 Lakeview Dr, Denver, NC 28037-9265 | 2020-03-03 |
| 1821637778 | Lisa Ann Smith | Dietitian, Registered | 522 10th St, Aplington, IA 50604-1073 | 2019-12-24 |
| 1700421450 | Lisa Marie Smith | Nurse Practitioner | 4353 Heyward St, North Port, FL 34291-4561 | 2019-11-16 |
| 1982168290 | Lisa Lynn Smith | Acupuncturist | 531 Central Park Avenue, Suite 304, Searsdale, NY 10583 | 2019-01-31 |
| 1649753120 | Lisa Lynn Smith | Occupational Therapist | 355 Dogwood South Ln, Haughton, LA 71037-8511 | 2018-09-11 |
| 1083193270 | Lisa Smith | Occupational Therapist | 243 Raspberry Rd, Leola, PA 17540-2215 | 2018-08-09 |
| Street Address |
2200 BERGQUIST DR STE 1 ATTN: CREDENTIALS |
| City | LACKLAND A F B |
| State | TX |
| Zip Code | 78236-9908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467891366 | Samantha Luanne Guy | Physician Assistant | 2200 Bergquist Dr Ste 1, Attn: Credentials (sghc), Lackland A F B, TX 78236-9908 | 2013-06-24 |
| 1427492545 | Oscar Escano | General Practice | 2200 Bergquist Dr Ste 1, 59 Mhs/sgowv1, Lackland A F B, TX 78236-9908 | 2013-04-19 |
| 1881935112 | J T Floyd | Physician Assistant | 2200 Bergquist Dr Ste 1, Attn: Credentials (sghc), Lackland A F B, TX 78236-9908 | 2013-03-12 |
| 1144583352 | Cleann Toner | Pharmacist | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2012-06-21 |
| 1417223561 | Nancy Vogelgesang | Pharmacist | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2012-03-22 |
| 1295011641 | Stephen Garrett Ray | Nurse Practitioner | 2200 Bergquist Dr Ste 1, Attn: Credentials (cmc), Lackland A F B, TX 78236-9908 | 2011-10-31 |
| 1396029559 | Daniel Sung Oh | Military Health Care Provider | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2011-10-06 |
| 1184919763 | Marley Cranford Smith | Case Manager/Care Coordinator | 2200 Bergquist Dr Ste 1, Attn: Credentials (cmc), Lackland A F B, TX 78236-9908 | 2011-06-13 |
| 1770881633 | Jennifer B Gillespie | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2011-03-02 |
| 1972804540 | Nilofer N Pervez Arthur | Pharmacist | 2200 Bergquist Dr Ste 1, Lackland Air Force Base, Lackland A F B, TX 78236-9908 | 2010-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609848241 | Mark W Pape | Military Health Care Provider | 312 Westover Rd, Suite 7, Lackland A F B, TX 78236-0121 | 2006-02-07 |
| 1780763334 | Lakisha Deshawnda Chaffin-hickerson | Military Health Care Provider | 2200 Bergquist Dr Ste 1, Department of Occupational Therapy, Whmc, Lackland A F B, TX 78236-9908 | 2006-11-03 |
| 1669488524 | Francisco Javier Dominguez | Military Health Care Provider | 2200 Bergquist Dr, Suite 1, Lackland A F B, TX 78236-9907 | 2006-07-31 |
| 1609806736 | Miguel A Montalvo | Military Health Care Provider | 2200 Bergquist Dr, Suite 1, Lackland A F B, TX 78236-9907 | 2006-07-04 |
| 1144290974 | William Kruyer | Military Health Care Provider | 2200 Bergquist Dr, Suite 1 - Credentials/cmc, Lackland A F B, TX 78236-9907 | 2006-01-24 |
| 1992783211 | Chung Siedlecki | Military Health Care Provider | 1515 Truemper St, Lackland A F B, TX 78236-5583 | 2006-01-06 |
| 1033197454 | Derek Kurt Urban | Military Health Care Provider | 2200 Bergquist Dr, Suite 1, Lackland A F B, TX 78236-9908 | 2006-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841805454 | Tri Huynh Minh Nguyen | Military Health Care Provider | 7826 Enchanted Cliff Dr, El Paso, TX 79911-7508 | 2020-09-10 |
| 1700355237 | William Christopher Petty | Military Health Care Provider | 21227 Torch Street, Biggs Field, TX 79918 | 2018-11-14 |
| 1346629094 | Grada Berry | Military Health Care Provider | 2520 Heather Brook Ln Apt 804, Arlington, TX 76006-5177 | 2015-05-28 |
| 1215323514 | Kathleen Schurr | Military Health Care Provider | 47th Medical Group, Laughlin Afb, TX 78840 | 2015-04-13 |
| 1639518616 | Treble Clef Technologies | Military Health Care Provider | 3233 Tomahawk St, El Paso, TX 79936-2315 | 2013-06-23 |
| 1679837355 | Jeffrey Hoffmann | Military Health Care Provider | 1640 N Zaragoza Rd, Apt 118, El Paso, TX 79936-8004 | 2012-06-27 |
| 1194022566 | William Resto-rivera | Military Health Care Provider | J Street Bldg 3000, Federal Medical Center Carswell, Fort Worth, TX 76127-0066 | 2011-02-22 |
| 1437456373 | Jennifer Leigh Noblin | Military Health Care Provider | Sheppard Afb Mental Health Clinic, 149 Hart St. Bldg 1200, Wichita Falls, TX 76311 | 2011-02-11 |
| 1609179159 | Verisha Virginia Dixon | Military Health Care Provider | 81945 Fm 2252 Ste 115, Cheroke Medical Services, Garden Ridge, TX 78266 | 2010-12-06 |
| 1215190004 | Joni Patricia Gumban | Military Health Care Provider | 409 Greene St, Webster, TX 77598-6701 | 2008-07-02 |
| Find all providers with the same taxonomy | ||||
| City | LACKLAND A F B |
| Zip Code | 78236 |
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| 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.