NPIMap

Individual provider Active NPI

Lisa Kaufmann, MD

  • Internal Medicine Physician
  • Boone, NC
National Provider Identifier
1023059987
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
85538 Issued in NC
Practice address
336 Deerfield Rd
Boone, NC 28607-5008
Phone
(828) 263-1211
Fax
(828) 262-4103
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 197282 NY
Internal Medicine Physician 207R00000X 85538 NC Primary

Addresses

Primary practice location

336 Deerfield Rd
Boone, NC 28607-5008

Mailing address

PO Box 3379
Boone, NC 28607-3379
Phone (877) 242-3459

Other identifiers 2

IdentifierTypeStateIssuer
1023059987MedicaidNC
01521677MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140528002157 NC Practitioner - Internal Medicine 2860534849 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
85538NCMDInternal Medicine Physician
197282NYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charles a. Cannon, Jr. Memorial Hospital, Inc Current Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc. Current Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc. Hospitalist CurrentSince Jul 1, 2014 Accepting new patients
Charles a Cannon Jr Memorial Hospital Inc CurrentSince Jul 1, 2014 Accepting new patients
Watauga Medical Center, Inc. Hospitalist CurrentSince Mar 1, 2014 Accepting new patients
Watauga Medical Center Inc CurrentSince Mar 1, 2014 Accepting new patients
University OB/GYN Associates Past Accepting new patients
Upstate Community Medical, PC Hospitalist PastSince Jun 30, 2007 Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc Past Accepting new patients
Watauga Medical Center, Inc. Past Accepting new patients

Locations

336 Deerfield Rd
Boone, NC 28607
Phone (828) 263-1211

155 Furman Rd
Ste 101
Boone, NC 28607
Phone (828) 262-4111

Interoperability endpoints

  • Direct secure messaging: lkaufmann495728@direct.unc.nchie.net

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1023059987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3379",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286073379",
            "telephone_number": "877-242-3459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 DEERFIELD RD",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286075008",
            "telephone_number": "828-263-1211",
            "fax_number": "828-262-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMANN",
        "first_name": "LISA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "197282",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "85538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023059987",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01521677",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, NC

Sources for this page

Verify at the official NPI Registry.