NPIMap

Individual provider Active NPI

Lisa Marie Ruggiero, NP-C

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1346882081
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
284281 Issued in NC
Practice address
1021 Morehead Medical Dr Ste a
Charlotte, NC 28204-2990
Phone
(828) 324-9550
Fax
(828) 324-4130
NPI assigned
Oct 15, 2019
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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 284281 NC Primary

Addresses

Primary practice location

1021 Morehead Medical Dr Ste a
Charlotte, NC 28204-2990

Mailing address

1021 Morehead Medical Dr Ste a
Charlotte, NC 28204-2990
Phone (828) 324-9550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220811000565 NC Practitioner - Nurse Practitioner 9032528138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Duke University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1021 Morehead Medical Dr
Suite a
Charlotte, NC 28204-2990
Phone (980) 442-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
284281NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Aug 1, 2022 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Aug 1, 2022 Accepting new patients

Locations

1021 Morehead Medical Dr
Ste A
Charlotte, NC 28204
Phone (704) 355-2884

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1346882081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 MOREHEAD MEDICAL DR STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042990",
            "telephone_number": "828-324-9550",
            "fax_number": "828-324-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 MOREHEAD MEDICAL DR STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042990",
            "telephone_number": "828-324-9550",
            "fax_number": "828-324-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUGGIERO",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2024-08-05",
        "certification_date": "2023-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "284281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.