Individual provider Active NPI

Lorie A Lisenby

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
National Provider Identifier
1578867313
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
085701 Issued in NC
Practice address
200 Hawthorne LN
Charlotte, NC 28204-2515
Phone
(704) 384-4000
NPI assigned
Jan 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 085701 NC Primary

Addresses

Primary practice location

200 Hawthorne LN
Charlotte, NC 28204-2515

Mailing address

347 Lakehurst Farm Rd
Norwood, NC 28128-6498
Phone (704) 459-0030

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address LLISENBY46070@DIRECT.NOVANTHEALTH.ORG

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110404000631 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739363417 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHS Anesthesia Services Group IncGroup PAC ID 5799007324, 742 clinicians

Practice addresses (Care Compare)

201 E Grover St
Shelby, NC 28150-3917
Phone (980) 487-3000

Hospital & facility affiliations

  • Stanly Regional Medical Center Hospital, Albemarle, NC, CCN 340119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1906NCMDOptician
085701NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Mar 1, 2016 Accepting new patients
CHS Anesthesia Services Group Inc CurrentSince Sep 1, 2017 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2016 Accepting new patients
The Presbyterian Hospital Nurse Anesthetist, Certified Registered CurrentSince Jan 31, 2011 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients

Locations

301 Yadkin St
Albemarle, NC 28001
Phone (704) 984-4000

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

433 McAlister Rd
Lincolnton, NC 28092
Phone (704) 512-7000

201 E Grover St
Shelby, NC 28150
Phone (704) 487-3000

Interoperability endpoints

  • Direct secure messaging: llisenby46070@direct.novanthealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1578867313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 LAKEHURST FARM RD",
            "city": "NORWOOD",
            "state": "NC",
            "postal_code": "281286498",
            "telephone_number": "704-459-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042515",
            "telephone_number": "704-384-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISENBY",
        "first_name": "LORIE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-10",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "085701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "LLISENBY46070@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "200 Hawthorne Ln",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.