Lisa Jett Mathis, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

19722 Issued in SC

Practice address

3021 Reidville Rd
Spartanburg, SC 29301-5643

Phone

(864) 576-9201

Fax

(864) 576-6584

NPI assigned

Oct 27, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1275905465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3021 REIDVILLE ROAD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29301",
            "telephone_number": "864-576-9201",
            "fax_number": "864-576-6584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 REIDVILLE RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293015643",
            "telephone_number": "864-576-9201",
            "fax_number": "864-576-6584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "LISA",
        "middle_name": "JETT",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-27",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Mason, PA
• Kathryn Massengill, PA-C
• Massive Medical Staffing LLC
• Trey Jeffrey Mathews, MD
• Denise Michelle Mathis
• Mary Carol Mathis, M.AUD.
• Richard Carl Mathis, DMD
• Brittany Nicole Matson, MHS, RD, LDN
• Matthew Evers, DMD, LLC
• Alisha Matthews

• Family Nurse Practitioner in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.