Individual provider Active NPI

Lisette Marie Garrett, MD

  • Pediatrics Physician
  • Somerset, KY
National Provider Identifier
1376513267
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
34521 Issued in KY
Practice address
350 Langdon St
Somerset, KY 42503-2786
Phone
(606) 678-8155
Fax
(606) 678-7548
NPI assigned
Jan 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 34521 KY Primary

Addresses

Primary practice location

350 Langdon St
Somerset, KY 42503-2786

Mailing address

350 Langdon St
Somerset, KY 42503-2786
Phone (606) 678-8155

Other identifiers 1

IdentifierTypeStateIssuer
64345218MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200206002087 KY Practitioner - Pediatric Medicine 6901232198 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34521KYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Family Medical Center Inc CurrentSince Dec 6, 2019 Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Dec 6, 2019 Accepting new patients
Cumberland Family Medical Center Inc Past Accepting new patients

Locations

360 Keen St
Burkesville, KY 42717
Phone (270) 864-1472

350 Langdon St
Somerset, KY 42503
Phone (606) 678-8155

350 Langdon St
#1
Somerset, KY 42503

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253145600000",
    "number": "1376513267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 LANGDON ST",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032786",
            "telephone_number": "606-678-8155",
            "fax_number": "606-678-7548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 LANGDON ST",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032786",
            "telephone_number": "606-678-8155",
            "fax_number": "606-678-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "LISETTE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2009-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "34521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64345218",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

Verify at the official NPI Registry.