Lisa R Pickett, D.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

8414 Issued in TN

Practice address

758 S. Willow Ave.,
Cookeville, TN 38501-3840

Phone

(931) 526-6173

Fax

(931) 526-6173

NPI assigned

Mar 16, 2006

Last updated

Mar 7, 2023By the provider in NPPES

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

Other identifiers 4

Other names 1

• Ms. Lisa Tittle Former name

Medicare fee-for-service enrollment

Enrolled in TN

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  TN

  Medicare reassignment NPD
• Putnam County Pediatrics, PLC

  dba Kids Kare Pediatrics

  • Pediatrics Physician
  • Cookeville, TN
  • NPI 1215054754
  NPD (past)
• Putnam County Pediatrics, PLC

  • Rural Health Clinic/Center
  • Cookeville, TN
  • NPI 1700712833
  NPD (past)

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1073582615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 S. WILLOW AVE.,",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013840",
            "telephone_number": "931-526-6173",
            "fax_number": "931-526-6173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "758 S. WILLOW AVE.,",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013840",
            "telephone_number": "931-526-6173",
            "fax_number": "931-526-6173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "LISA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "D.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN8418",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "8414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "APN8418",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q004696",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN BOARD OF NURSING",
            "identifier": "3207",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "4123798",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "TITTLE",
            "prefix": "MS.",
            "credential": "D.N.P",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jenny Fay Phillips, R.N.
• Macy Brooke Phillips
• Taylor Phillips, PT
• Christopher David Phipps, PT
• Amanda Leann Phy, LPC-MHSP
• Mark Arden Pierce, MD
• Tyona Pike
• Nicole Pisapia, D.O
• Shanti Pittampalli, MD
• Joann Maria Pitti, COTA

• Family Nurse Practitioner in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.