Individual provider Active NPI

Lisa R Lafata

  • Family Nurse Practitioner
  • Mount Olive, NC
National Provider Identifier
1639586704
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5007011 Issued in NC
Practice address
325 NC Highway 55 W
Mount Olive, NC 28365-8527
Phone
(919) 658-5900
Fax
(910) 267-8981
NPI assigned
Jul 21, 2014
Last updated
Mar 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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 5007011 NC Primary

Addresses

Primary practice location

325 NC Highway 55 W
Mount Olive, NC 28365-8527

Mailing address

1011 Rock Quarry Rd
Raleigh, NC 27610-3825
Phone (919) 658-5900

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
I20141015002189 NC Practitioner - Nurse Practitioner 6901027994 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Duke University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Family Care Fuquay PLLCGroup PAC ID 6103258306, 33 clinicians

Practice addresses (Care Compare)

1298 N Main St
Fuquay Varina, NC 27526-2615
Phone (919) 590-4099

325 NC Hwy 55 W
Mount Olive, NC 28365-8527
Phone (919) 658-5900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5007011NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Medical Center Incorporated CurrentSince Aug 14, 2014 Accepting new patients
Goshen Medical Center Incorporated Current Accepting new patients
Goshen Medical Center Incorporated CurrentSince Aug 14, 2014 Accepting new patients
American Family Care Fuquay PLLC CurrentSince Dec 18, 2024 Accepting new patients
Goshen Medical Center, Incorporated Current Accepting new patients
Goshen Medical Center Incorporated Past Accepting new patients

Locations

444 SW Center St
Faison, NC 28341
Phone (910) 267-0421

1298 N Main St
Fuquay Varina, NC 27526
Phone (919) 590-4099

104 Adair Dr
Goldsboro, NC 27530
Phone (919) 648-4435

325 NC Highway 55 W
Mount Olive, NC 28365
Phone (919) 658-5900

Interoperability endpoints

  • Direct secure messaging: lisa.lafata.1@14940.direct.athenahealth.com
  • Direct secure messaging: llafata@goshenmedical.cloudcraftdirect.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1639586704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 ROCK QUARRY RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276103825",
            "telephone_number": "919-658-5900",
            "fax_number": "910-267-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 NC HIGHWAY 55 W",
            "city": "MOUNT OLIVE",
            "state": "NC",
            "postal_code": "283658527",
            "telephone_number": "919-658-5900",
            "fax_number": "910-267-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFATA",
        "first_name": "LISA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-21",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Olive, NC

Sources for this page

Verify at the official NPI Registry.