Individual provider Active NPI

Lisa S Carr, CNP

  • Nurse Practitioner
  • Thomasville, GA
National Provider Identifier
1073568630
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN077674 Issued in GA
Practice address
918 S Broad St
Thomasville
Thomasville, GA 31792-0918
Phone
(229) 226-8800
Fax
(229) 226-8232
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN077674 GA Primary

Addresses

Primary practice location

918 S Broad St
Thomasville
Thomasville, GA 31792-0918

Mailing address

PO Box 2357
Thomasville
Thomasville, GA 31799-2357
Phone (229) 226-8800

Other identifiers 2

IdentifierTypeStateIssuer
00481698DMedicaidGA
00481698BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20040329001168 GA Practitioner - Nurse Practitioner 3476445800 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians

Practice addresses (Care Compare)

101 Yorktown Dr
Fayetteville, GA 30214-1578

101 Yorktown Dr
Suite 100
Fayetteville, GA 30214-7663
Phone (770) 460-4285

2484 E Pinetree Blvd
Thomasville, GA 31792-4854
Phone (229) 594-6800

Hospital & facility affiliations

  • Archbold Memorial Hospital Hospital, Thomasville, GA, CCN 110038

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shaw Living PC CurrentSince Oct 1, 2019 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Mar 19, 2025 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Mar 19, 2025 Accepting new patients
Shaw Center for Women'S Health CurrentSince Oct 1, 1996 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

3715 Northside Pkwy NW
Bldg 100
Atlanta, GA 30327
Phone (404) 262-7414

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

103 E Davis St
Quitman, GA 31643
Phone (229) 263-7868

905 N Court St
Quitman, GA 31643
Phone (229) 263-8956

2484 E Pinetree Blvd
Thomasville, GA 31792
Phone (229) 226-8800

918 S Broad St
Thomasville, GA 31792
Phone (229) 226-8800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: lisa.carr.1@8042.direct.athenahealth.com
  • Direct secure messaging: lisa.carr@shawcenter.gadirect.net
  • Direct secure messaging: lisacarr@scwhpa.allscriptsdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1073568630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2357",
            "address_2": "THOMASVILLE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317992357",
            "telephone_number": "229-226-8800",
            "fax_number": "229-226-8232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 S BROAD ST",
            "address_2": "THOMASVILLE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317920918",
            "telephone_number": "229-226-8800",
            "fax_number": "229-226-8232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "LISA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN077674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00481698D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00481698B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

Verify at the official NPI Registry.