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1750384277

NPI Code Detail

MEDICARE: DR. LISA K HEINEMEYER-FOSTER M.D.

MEDICARE: DR. LISA K HEINEMEYER-FOSTER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35064298H	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080191706	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	35064298	OTHER	OH	MEDICAL LICENSE
3	421534506079	OTHER	OH	CARESOURCE
4	638336	OTHER	OH	AETNA
5	24260	OTHER	OH	NATIONWIDE HEALTH PLAN
6	000000227880	OTHER	OH	ANTHEM
7	0122513	OTHER	OH	UNITE HEALTH CARE
8	281697850007	OTHER	OH	MEDICAL MUTUAL OF OHIO
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	D64298	OTHER	OH	HUMANA/CHOICECARE

General Provider Information

NPI Number	:	1750384277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA K HEINEMEYER-FOSTER M.D.

Provider Business Mailing Address
First Line	:	68 DARST RD
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45440-3442
Country	:	US
Telephone Number	:	937-531-0132
Fax Number	:	937-531-0134

Provider Business Practice Location Address
First Line	:	68 DARST RD
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45440-3442
Country	:	US
Telephone Number	:	937-531-0132
Fax Number	:	937-531-0134

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2005
Last Update Date	:	01/25/2021

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1356992028 — ZACHARY JAMES HALE APRN, NP-C
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Directions to “ DR. LISA K HEINEMEYER-FOSTER M.D.” Practice Location

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