Lisa Patterson Faircloth, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

154242 Issued in GA

Practice address

906 N 5TH St Ste D
Cordele, GA 31015-3224

Phone

(229) 271-4630

Fax

(229) 271-4631

NPI assigned

Sep 2, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lisafaircloth@centralgauro.medalliesdirect.net

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.

• 2406 Cancer Care LLC

  • Urology Physician
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  • NPI 1215703046
  NPD
• Urological Health Center, PC

  • Urology Physician
  • Cordele, GA
  • NPI 1578624367
  NPD (past)

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508968256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 N 5TH ST STE D",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153224",
            "telephone_number": "229-271-4630",
            "fax_number": "229-271-4631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 N 5TH ST STE D",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153224",
            "telephone_number": "229-271-4630",
            "fax_number": "229-271-4631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRCLOTH",
        "first_name": "LISA",
        "middle_name": "PATTERSON",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "154242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sherry Evans, ATR
• Judy Lynn Fajardo, AGCANP-BC
• Tiffany Merritt Fallin, NP
• Lauren Goforth Faulk, APRN, FNP-C
• Mary Gail Ferra, NPC
• Kenya Lavette Fields

• All providers in Cordele, GA
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.