Individual provider Active NPI

Lisa C Fleck, PA-C

  • Medical Physician Assistant
  • Charlotte, NC
National Provider Identifier
1639166465
Registry record updated Dec 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
102274 Issued in NC
Practice address
700 E Morehead St Ste 300
Charlotte, NC 28202-2742
Phone
(704) 334-7800
Fax
(704) 414-7512
NPI assigned
Oct 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 102274 NC Primary

Addresses

Primary practice location

700 E Morehead St Ste 300
Charlotte, NC 28202-2742

Mailing address

700 E Morehead St Ste 300
Charlotte, NC 28202-2742
Phone (704) 334-7800

Other practice location 1

1701 East Blvd
Charlotte, NC 28203-5823
Phone (704) 334-7800

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
I20060323000262 NC Practitioner - Physician Assistant 3577571165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charlotte Radiology PAGroup PAC ID 4587577390, 222 clinicians

Practice addresses (Care Compare)

Charlotte, NC 28202
Phone (704) 362-5391

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 362-1945

724 Aubrey Bell Dr
Matthews, NC 28105-5055
Phone (704) 295-3550

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Radiology P a CurrentSince Jan 1, 2010 Accepting new patients
Cabarrus Family Medicine Past Accepting new patients
Cabarrus Family Medicine Past Accepting new patients

Locations

700 E Morehead St
Ste 300
Charlotte, NC 28202
Phone (704) 442-4390

12335 N Community House Rd
Ste B
Charlotte, NC 28277

270 Copperfield Blvd NE
Ste 201
Concord, NC 28025
Phone (704) 403-1911

724 Aubrey Bell Dr
Matthews, NC 28105
Phone (704) 295-3550

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/c32cb33f-ec61-4f25-9140-0b9b174fe4db/

Organizations & group practices 3

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 6

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1639166465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022742",
            "telephone_number": "704-334-7800",
            "fax_number": "704-414-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022742",
            "telephone_number": "704-334-7800",
            "fax_number": "704-414-7512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 East Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035823",
            "country_code": "US",
            "telephone_number": "704-334-7800",
            "fax_number": "704-414-7512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLECK",
        "first_name": "LISA",
        "middle_name": "C",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "102274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.