Individual provider Active NPI

Lisa Marie Carter, FNP

  • Nurse Practitioner
  • Mount Juliet, TN
National Provider Identifier
1336130558
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
334708 Issued in NY
Practice address
906 Harrisburg Lane
Mount Juliet, TN 37122
Phone
(615) 288-2472
Fax
(315) 798-1707
NPI assigned
Nov 4, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 334708 NY Primary

Addresses

Primary practice location

906 Harrisburg Lane
Mount Juliet, TN 37122

Mailing address

906 Harrisburg Lane
Mount Juliet, TN 37122
Phone (615) 288-2472

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140310001241 NY Order and Referring Only - Nurse Practitioner 1153331350

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
334708NYMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1336130558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 HARRISBURG LANE",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "37122",
            "telephone_number": "615-288-2472",
            "fax_number": "315-798-1707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 HARRISBURG LANE",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "37122",
            "telephone_number": "615-288-2472",
            "fax_number": "315-798-1707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "334708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Juliet, TN

Sources for this page

Verify at the official NPI Registry.