Lisa Vivienne Poling, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN067035NP Issued in GA

Practice address

1000 Chastain Rd NW
Kennesaw, GA 30144-5588

Phone

(678) 797-2844

Fax

(678) 797-2827

NPI assigned

Apr 28, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Lisa Vivienne Melnick Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Amelia Urgent Care LLC

  • Urgent Care Clinic/Center
  • Fernandina Beach, FL
  • NPI 1841366812
  Medicare reassignment NPD
• Amelia Urgent Care LLC

  • Urgent Care Clinic/Center
  • Jacksonville, FL
  • NPI 1982844163
  NPD

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1003050576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CHASTAIN RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301445588",
            "telephone_number": "678-797-2844",
            "fax_number": "678-797-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CHASTAIN RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301445588",
            "telephone_number": "678-797-2844",
            "fax_number": "678-797-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLING",
        "first_name": "LISA",
        "middle_name": "VIVIENNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-28",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN067035NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "MELNICK",
            "middle_name": "VIVIENNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Plastic Surgery Associates
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• Robert Earl Poindexter Jr., DMD
• Peter John Pomazon, D.M.D.
• Kathleen Poore
• Emily Danielle Pope, BCBA
• Karen Porter, RD, LD
• Tyrone Portis

• Family Nurse Practitioner in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.