LISA STADUM NP
NPI 1063577161
Nurse Practitioner - Family in Prescott, AZ

Q: What is Lisa Stadum's NPI number?

The NPI number for Lisa Stadum is 1063577161. It was assigned to this individual provider in the NPPES registry on December 27, 2006.

Q: What is Lisa Stadum's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Stadum was last updated on August 17, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since December 27, 2006PECOS Enrolled

2100 CENTERPOINTE WEST DR, PRESCOTT, AZ 86301(928) 717-0788(928) 717-0748 Get Directions Write a Review

NPPES record last updated: August 17, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Lisa Stadum Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LISA STADUM NP (NPI 1063577161) is an individual family provider in Prescott, Arizona, licensed in Arizona (AP2577) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063577161

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameLISA STADUMCredential: NP

Location Address2100 CENTERPOINTE WEST DRPrescott, AZ 86301-8487

Mailing Address2100 Centerpointe West DrPrescott, AZ 86301-8487 · (928) 717-0788 · Fax (928) 717-0748

Phone(928) 717-0788

Fax(928) 717-0748

Sole ProprietorYes

Enumeration DateDecember 27, 2006

Last NPPES UpdateAugust 17, 2011

✔ NPI 1063577161 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in AZ · AP2577

2100 CENTERPOINTE WEST DR, Prescott, AZ 86301

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa Stadum Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 86301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CHRISTOPHER AARON JOHNS M.D.

Physical Medicine & Rehabilitation