Individual provider Active NPI

Lisa Renee Stone, CRNP

  • Family Nurse Practitioner
  • Winchester, TN
National Provider Identifier
1124486725
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
32412 Issued in TN
Practice address
2401 Decherd Blvd
Winchester, TN 37398-1164
Phone
(931) 313-1388
Fax
(931) 313-1392
NPI assigned
Feb 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F0116632 AL
Family Nurse Practitioner 363LF0000X 32412 TN Primary

Addresses

Primary practice location

2401 Decherd Blvd
Winchester, TN 37398-1164

Mailing address

2401 Decherd Blvd
Winchester, TN 37398-1164
Phone (931) 313-1388

Other practice location 1

2505 US Highway 431
Boaz, AL 35957-5908
Phone (256) 593-8310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160520000509 AL Practitioner - Nurse Practitioner 1850680497 Reassigns benefits to 1 organization
I20240228003100 TN Practitioner - Nurse Practitioner 1850680497 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F0116632ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Jan 10, 2024 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Jan 10, 2024 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Aug 1, 2024 Accepting new patients
Family First Medicine LLC Past Accepting new patients

Locations

416 N Seminary St
Ste 1100
Florence, AL 35630
Phone (256) 284-7280

10210 Highway 431 S
New Hope, AL 35760
Phone (256) 936-5232

1415 Hillsboro Blvd
Ste 6
Manchester, TN 37355

2401 Decherd Blvd
Winchester, TN 37398
Phone (931) 313-1388

Organizations & group practices 4

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": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1124486725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 DECHERD BLVD",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373981164",
            "telephone_number": "931-313-1388",
            "fax_number": "931-313-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 DECHERD BLVD",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373981164",
            "telephone_number": "931-313-1388",
            "fax_number": "931-313-1392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2505 US Highway 431",
            "address_purpose": "LOCATION",
            "city": "Boaz",
            "state": "AL",
            "postal_code": "359575908",
            "country_code": "US",
            "telephone_number": "256-593-8310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STONE",
        "first_name": "LISA",
        "middle_name": "RENEE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-10",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "F0116632",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "32412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, TN

Sources for this page

Verify at the official NPI Registry.