Lotus Clinic PLLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

LOTUS CLINIC PLLC

Practice address

208 McKoy St
Clinton, NC 28328-3402

Phone

(910) 763-7151

Fax

(910) 310-4047

NPI assigned

Apr 25, 2022

Organization subpart

No

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

Authorized official

Name

Nicole Mishonda Blue, FNP

Title

Administrator

Phone

(910) 719-9134

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652659200000",
    "number": "1568106557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 MCKOY ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283283402",
            "telephone_number": "910-719-9134",
            "fax_number": "910-310-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 MCKOY ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283283402",
            "telephone_number": "910-763-7151",
            "fax_number": "910-310-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOTUS CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-25",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A",
        "authorized_official_last_name": "BLUE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "MISHONDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "910-719-9134",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Yvonne Linn
• Christopher Little, MD
• Donald Lugo
• Olivia Shipp Lynch
• Laura M Malnar, MBA RD LDN
• Sharry Jackson Malpass, DNP, NP-C, FNP-BC
• Tara Lynn Marr-Carter, FNP

• Nurse Practitioner in Clinton, NC
• Providers in Clinton, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; 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.