Individual provider Active NPI

Lisa Terrell Crews, NP

  • Adult Health Nurse Practitioner
  • Hinesville, GA
National Provider Identifier
1053635763
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN113544 Issued in GA
Practice address
455 S Main St Ste 104
Hinesville, GA 31313-4354
Phone
(912) 876-5644
Fax
(912) 877-6341
NPI assigned
Mar 24, 2010
Last updated
May 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN113544 GA Primary

Addresses

Primary practice location

455 S Main St Ste 104
Hinesville, GA 31313-4354

Mailing address

455 S Main St Ste 104
Hinesville, GA 31313-4354
Phone (912) 876-5644

Other practice location 1

586 Islands Highway
Midway, GA 31320
Phone (912) 369-9302

Other practice location 2

73 Coastal Manor Dr SE
Ludowici, GA 31316-2949
Phone (912) 369-9313

Other names 1

  • Lisa Renee Terrell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 1, 2025 through Jul 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN113544GAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher a. Kuettner, MD Past Accepting new patients
SJC Medical Group Inc PastSince Mar 2, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1053635763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST STE 104",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134354",
            "telephone_number": "912-876-5644",
            "fax_number": "912-877-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST STE 104",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134354",
            "telephone_number": "912-876-5644",
            "fax_number": "912-877-6341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "586 Islands Highway",
            "address_purpose": "LOCATION",
            "city": "Midway",
            "state": "GA",
            "postal_code": "31320",
            "country_code": "US",
            "telephone_number": "912-369-9302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "73 Coastal Manor Dr SE",
            "address_purpose": "LOCATION",
            "city": "Ludowici",
            "state": "GA",
            "postal_code": "313162949",
            "country_code": "US",
            "telephone_number": "912-369-9313",
            "fax_number": "912-545-0043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CREWS",
        "first_name": "LISA",
        "middle_name": "TERRELL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN113544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "TERRELL",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hinesville, GA

Sources for this page

Verify at the official NPI Registry.