Active NPI
Lara E Gerrard, LPA
- Clinical Psychologist
- Goldsboro, NC
National Provider Identifier
1194865550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1567
- Practice address
- 600 N Madison Ave
Goldsboro, NC 27530-3143 - Phone
- (919) 739-0047
- Fax
- (919) 739-9041
- NPI assigned
- Feb 7, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1567 | NC | Primary |
Addresses
Primary practice location
600 N Madison Ave
Goldsboro, NC 27530-3143
Mailing address
PO Box 362
Pikeville, NC 27863-0362
Phone (919) 739-0047
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1567 | Other | NC | NC STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1567 | NC | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194865550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 362",
"city": "PIKEVILLE",
"state": "NC",
"postal_code": "278630362",
"telephone_number": "919-739-0047",
"fax_number": "919-739-9041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N MADISON AVE",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275303143",
"telephone_number": "919-739-0047",
"fax_number": "919-739-9041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERRARD",
"first_name": "LARA",
"middle_name": "E",
"credential": "LPA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "1567",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC STATE LICENSE",
"identifier": "1567",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Goldsboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.