Individual provider Active NPI

Lisa Kott-Harrington, FNP-C

  • Nurse Practitioner
  • Fredericksburg, TX
National Provider Identifier
1689057010
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP128417 Issued in TX
Practice address
1308 S State Highway 16
Fredericksburg, TX 78624-5058
Phone
(830) 997-2181
Fax
(830) 997-4453
NPI assigned
Jul 2, 2015
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP128417 TX
Nurse Practitioner 363L00000X AP128417 TX Primary

Addresses

Primary practice location

1308 S State Highway 16
Fredericksburg, TX 78624-5058

Mailing address

1308 S State Highway 16
Fredericksburg, TX 78624-5058
Phone (830) 997-2181

Other identifiers 1

IdentifierTypeStateIssuer
357537504MedicaidTX

Other names 1

  • Lisa Michelle Olson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160427000431 TX Practitioner - Nurse Practitioner 4688973548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fredericksburg Clinic PLLCGroup PAC ID 3375515992, 10 clinicians

Practice addresses (Care Compare)

1308 S Hwy 16
Fredericksburg, TX 78624-5058
Phone 8309972181290

Hospital & facility affiliations

  • Hill Country Memorial Hospital Hospital, Fredericksburg, TX, CCN 450604
  • Peterson Regional Medical Center Hospital, Kerrville, TX, CCN 450007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fredericksburg Clinic, PLLC CurrentSince Mar 12, 2018 Accepting new patients

Locations

1308 S State Highway 16
Fredericksburg, TX 78624
Phone (830) 997-2181

Interoperability endpoints

  • Direct secure messaging: lisa.kott-harrington@854391770316804.direct.elationemr.com

Organizations & group practices 1

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": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1689057010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 S STATE HIGHWAY 16",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786245058",
            "telephone_number": "830-997-2181",
            "fax_number": "830-997-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 S STATE HIGHWAY 16",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786245058",
            "telephone_number": "830-997-2181",
            "fax_number": "830-997-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTT-HARRINGTON",
        "first_name": "LISA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP128417",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP128417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "357537504",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "OLSON",
            "middle_name": "MICHELLE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fredericksburg, TX

Sources for this page

Verify at the official NPI Registry.