Lisa Kaye Proffitt, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3005252 Issued in KY

Practice address

405 S L Rogers Wells Blvd
Glasgow, KY 42141-1725

Phone

(270) 479-0260

Fax

(270) 361-5001

NPI assigned

Jul 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Lisa Kaye Grimes Former name

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Graves Gilbert Clinic PLLCGroup PAC ID 4082511167, 207 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lisaproffitt@ggc.allscriptsdirect.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.

• Graves Gilbert Clinic PLLC

  • Specialist
  • Bowling Green, KY
  • NPI 1114948288

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Graves Gilbert Clinic PLLC

  • Rural Health Clinic/Center
  • Cave City, KY
  • NPI 1104635663
  NPD
• Zipclinic, PSC

  • Primary Care Clinic/Center
  • Bowling Green, KY
  • NPI 1861873507
  NPD

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1649460544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011742",
            "telephone_number": "270-781-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S L ROGERS WELLS BLVD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411725",
            "telephone_number": "270-479-0260",
            "fax_number": "270-361-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROFFITT",
        "first_name": "LISA",
        "middle_name": "KAYE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3005252",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "5252P",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3005252",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100020460",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "GRIMES",
            "middle_name": "KAYE",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Primary Care Associates of Southern Kentucky, PLLC
• Primary Care Associates of Southern Kentucky, PLLC
• Pro Pharmacy LLC
• Professional Surgical Assisting Services
• Ashley Proffitt, BHS
• Psychiatric Wellness Associates
• Puckett Counseling Services
• Peggy Smith Puckett, LMFT
• Rhonda Brooks Quenzer, APRN, PMHNP
• R David Fant MD PSC

• Family Nurse Practitioner in Glasgow, KY
• Providers in Glasgow, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.
• 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.