Lisa Jervis

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

9900072 Issued in NC

Practice address

125 Queens Rd Ste 500
Charlotte, NC 28204-3215

Phone

(980) 302-6380

Fax

(980) 302-6385

NPI assigned

Jul 19, 2006

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Laurel OB GYN Associates, P.a.

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
  • NPI 1528124245
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1376562108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "980-302-6380",
            "fax_number": "980-302-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043215",
            "telephone_number": "980-302-6380",
            "fax_number": "980-302-6385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERVIS",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "9900072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ljervis692280@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "125 Queens Rd Ste 500",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Peter A Jernigan, MD
• Ann-Sophie Jerome, LCMHCA, CRC
• Kai Jerrell, M.A. CCC-SLP
• Jerry a. Jones, M.D., P.a.
• Emily Denise Jerry, MSW
• Oliver Wheeler Jervis Jr., M.D.
• Jerzeygirlhair Salon
• Jess Let It Simmer
• Jesse C. Bradford, D.D.S., P.L.L.C.
• Melissa E Jesse, NP

• Obstetrics & Gynecology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Obstetrics & Gynecology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.