Lisa Byrd Healthcare Inc

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F0811435 Issued in MS

Legal business name

LISA BYRD HEALTHCARE INC

Doing business as

Bolton Family Clinic

Practice address

115 W Madison St
Bolton, MS 39041-3209

Phone

(601) 866-7723

Fax

(601) 866-7773

NPI assigned

Oct 18, 2011

Last updated

Oct 18, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa Byrd, PHD, NPNPI 1407845829

Title

President

Phone

(601) 866-7723

Specialties & licenses 1

Addresses

Other names 1

• Bolton Family Clinic Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa Byrd, PHD,APRN,FNP-BC,GNP-

  • Nurse Practitioner
  • Pembroke Pines, FL
  • NPI 1407845829

  Family

  NPD Authorized official

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318896000000",
    "number": "1649555095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W MADISON ST",
            "city": "BOLTON",
            "state": "MS",
            "postal_code": "390413209",
            "telephone_number": "601-866-7723",
            "fax_number": "601-866-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W MADISON ST",
            "city": "BOLTON",
            "state": "MS",
            "postal_code": "390413209",
            "telephone_number": "601-866-7723",
            "fax_number": "601-866-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA BYRD HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-18",
        "last_updated": "2011-10-18",
        "status": "A",
        "authorized_official_last_name": "BYRD",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-866-7723",
        "authorized_official_credential": "PHD, NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "F0811435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bolton Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Central Mississippi Civic Improvement Association, Inc (Jackson Hinds Comprehensive Health Center)
• Dr Robert Woodruff DPM PA
• Janet Gray
• Health Wellness Promotion LLC (Bolton Family Clinic)
• Lisa Byrd Healthcare Inc (Bolton Family Clinic)
• Jean Pennington Marks, GNP-BC
• Mississippi Nurse Practitioners Inc
• Fredrica Oliver
• Amy Monett-Shamon Shoulders Thomas, FNP-C
• Alisha White

• Family Nurse Practitioner in Bolton, MS
• Providers in Bolton, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; 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.