Active NPI
Lisa Carr
- Pharmacist
- Leesburg, GA
National Provider Identifier
1437556859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19406
- Practice address
- 113 Ambleside Dr
Leesburg, GA 31763-5346 - Phone
- (229) 395-0302
- NPI assigned
- Dec 1, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 19406 | GA | Primary |
| Pharmacist | 183500000X | PS29563 | FL | |
| Pharmacist | 183500000X | 8748 | SC |
Addresses
Primary practice location
113 Ambleside Dr
Leesburg, GA 31763-5346
Mailing address
113 Ambleside Dr
Leesburg, GA 31763-5346
Phone (229) 395-0302
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 328347 | Other | NABP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8748 | SC | MD | Dentist Anesthesiologist |
| PS29563 | FL | MD | Pharmacist |
| 19406 | GA | MD | Cardiovascular Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417392000000",
"number": "1437556859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 AMBLESIDE DR",
"city": "LEESBURG",
"state": "GA",
"postal_code": "317635346",
"telephone_number": "229-395-0302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 AMBLESIDE DR",
"city": "LEESBURG",
"state": "GA",
"postal_code": "317635346",
"telephone_number": "229-395-0302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARR",
"first_name": "LISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-01",
"last_updated": "2014-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "19406",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS29563",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "8748",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "328347",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Leesburg, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.