Lisa M. Delacruz, PNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5006132 Issued in NC

Practice address

14215 Ballantyne Corporate PL
Suite 130
Charlotte, NC 28277-3670

Phone

(704) 384-1950

Fax

(704) 384-1955

NPI assigned

Dec 18, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

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.

• Carolina Medicorp Enterprises, LLC

  • Urgent Care Clinic/Center
  • Charlotte, NC
  • NPI 1760950646
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• Carolina Medicorp Enterprises, LLC

  • Urgent Care Clinic/Center
  • Asheville, NC
  • NPI 1235014796
  NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
  • NPI 1982945242
  NPD

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

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1063758142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-1440",
            "fax_number": "704-384-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14215 BALLANTYNE CORPORATE PL",
            "address_2": "SUITE 130",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773670",
            "telephone_number": "704-384-1950",
            "fax_number": "704-384-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELACRUZ",
        "first_name": "LISA",
        "middle_name": "M.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-18",
        "last_updated": "2020-10-28",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "20122290",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5006132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgrote317025@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "14215 Ballantyne Corporate Pl",
            "address_2": "Suite 130",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282773670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kerby Dejesus, BCBA, M. ED
• Taisha Dejesus
• Janet Marie Dejohn
• Arjay Alberto Del Rosario, PT
• Bailey Michelle Del Vecchio, RDN, LDN
• Delacy C LLC
• Mark Deland, PHARM.D
• Christine E. Delaney, LCSW
• Devon Briggs Delaney, MD
• Paul Patrick Delaney, PA-C

• Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.