Active NPI
Clarissa G Lawrence, MD
- Pediatrics Physician
- Wilson, NC
National Provider Identifier
1306922562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0101262369
- Practice address
- 1702 Medical Park Dr W
Wilson, NC 27893-2705 - Phone
- (252) 243-7944
- Fax
- (252) 243-6097
- NPI assigned
- Oct 31, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0101262369 | VA | Primary |
Addresses
Primary practice location
1702 Medical Park Dr W
Wilson, NC 27893-2705
Mailing address
1020 Terrace Dr
Suite 101
Marion, VA 24354-4392
Phone (276) 783-8183
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306922562 | Medicaid | VA | |
| 8951212 | Medicaid | NC |
Other names 1
- Dr. Leesa M Lawrence
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171208001822 | VA | Practitioner - Pediatric Medicine | 8224395702 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- leesalawrence@ropa.ssdirect.aprima.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1306922562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 TERRACE DR",
"address_2": "SUITE 101",
"city": "MARION",
"state": "VA",
"postal_code": "243544392",
"telephone_number": "276-783-8183",
"fax_number": "276-782-9267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1702 MEDICAL PARK DR W",
"city": "WILSON",
"state": "NC",
"postal_code": "278932705",
"telephone_number": "252-243-7944",
"fax_number": "252-243-6097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAWRENCE",
"first_name": "CLARISSA",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-31",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0101262369",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1306922562",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8951212",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LEESA",
"last_name": "LAWRENCE",
"middle_name": "M",
"prefix": "DR.",
"credential": "MD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Wilson, NC
- Jean Langston, PT
- Kylee Jai Lashomb
- Linda Osment Lathan, FNP
- Jacob Latkofsky, PT, DPT
- Maryrussell Wagstaff Laurent, PHARMD, MSCR, BCPS
- Le Chris Adult Day Care of Rocky Mount, Inc.
- Le Chris Health Systems of Wilson, Inc
- Lechris Adult Day Care of Rocky Mount, Inc.
- Ashley James Lee, OTA
- Cyrus Andrew Lee, D.D.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.