Individual provider Active NPI

Lisa Marie Scholz, NP

  • Adult Health Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1164734885
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
29328 Issued in TN
Practice address
2151 Century LN
Johnson City, TN 37604-4469
Phone
(423) 926-2500
Fax
(423) 926-5999
NPI assigned
Jul 10, 2010
Last updated
Oct 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F303411 NY
Adult Health Nurse Practitioner 363LA2200X 29328 TN Primary

Addresses

Primary practice location

2151 Century LN
Johnson City, TN 37604-4469

Mailing address

PO Box 70403
Johnson City, TN 37614-1703
Phone (423) 439-4059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, 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
I20150407000849 NY Practitioner - Nurse Practitioner 7315265105 Reassigns benefits to 1 organization
I20211119002335 TN Practitioner - Nurse Practitioner 7315265105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Tennessee State UniversityGroup PAC ID 2769394774, 21 clinicians

Practice addresses (Care Compare)

202 W Fairview Ave
Johnson City, TN 37604-5611
Phone (423) 439-7371

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F303411NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee State University CurrentSince Oct 1, 2021 Accepting new patients
East Tennessee State University CurrentSince Oct 1, 2021 Accepting new patients
The Long Island Home CurrentSince Jan 1, 2015 Accepting new patients
The Long Island Home CurrentSince Jan 1, 2015 Accepting new patients
North Suffolk Cardiology-Stony Brook Community Medical, PC Past Accepting new patients
East Tennessee State University Past Accepting new patients

Locations

400 Sunrise Hwy
Amityville, NY 11701
Phone (631) 264-4000

202 W Fairview Ave
Johnson City, TN 37604
Phone (423) 439-7371

2151 Century Ln
Johnson City, TN 37604
Phone (423) 439-4071

2700 Main St
Sneedville, TN 37869
Phone (423) 733-2819

Organizations & group practices 6

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": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1164734885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70403",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376141703",
            "telephone_number": "423-439-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 CENTURY LN",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376044469",
            "telephone_number": "423-926-2500",
            "fax_number": "423-926-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOLZ",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-10",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F303411",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TN",
            "license": "29328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.