Individual provider Active NPI

Laura Christine Lisicki, MS, FNP-BC

  • Family Nurse Practitioner
  • Cary, NC
National Provider Identifier
1508083536
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201943 Issued in NC
Practice address
930 SE Cary Parkway
Cary, NC 27518
Phone
(919) 859-2566
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201943 NC Primary

Addresses

Primary practice location

930 SE Cary Parkway
Cary, NC 27518

Mailing address

3713 Grandbridge Drive
Apex, NC 27539
Phone (919) 773-9302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20140225002035 NC Practitioner - Nurse Practitioner 1254561988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
201943NCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cary Adult Medicine PLLC CurrentSince Jan 14, 2014 Accepting new patients

Locations

930 SE Cary Pkwy
Ste 200
Cary, NC 27518
Phone (919) 859-2566

Interoperability endpoints

  • Direct secure messaging: llisicki@carymed.amazing-direct.com

Organizations & group practices 1

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508083536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3713 GRANDBRIDGE DRIVE",
            "city": "APEX",
            "state": "NC",
            "postal_code": "27539",
            "telephone_number": "919-773-9302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 SE CARY PARKWAY",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27518",
            "telephone_number": "919-859-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISICKI",
        "first_name": "LAURA",
        "middle_name": "CHRISTINE",
        "credential": "MS, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "201943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.