Lora Mutiso, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3004380 Issued in KY

Practice address

1306 Versailles Rd
Suite 120
Lexington, KY 40504-1796

Phone

(859) 259-2635

Fax

(859) 254-7874

NPI assigned

Apr 2, 2007

Last updated

Apr 23, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bluegrass Primary Health Care Center, Inc.Group PAC ID 7810326915, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bluegrass Primary Health Care Center, Inc.

  dba Bluegrass Community Health Center-Versailles Road

  • Federally Qualified Health Center (FQHC)
  • Lexington, KY
  • NPI 1215567474
  Medicare reassignment Care Compare group NPD
• Bluegrass Primary Health Care Center, Inc.

  dba Bluegrass Community Health Center-New Life

  • Federally Qualified Health Center (FQHC)
  • Lexington, KY
  • NPI 1073144481
  NPD
• Bluegrass Primary Health Care Center, Inc.

  dba Bluegrass Community Health Center-George Rogers Clark HighSchoolClinic

  • Federally Qualified Health Center (FQHC)
  • Winchester, KY
  • NPI 1447009303
  NPD

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1689795536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 VERSAILLES RD",
            "address_2": "SUITE 120",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405041796",
            "telephone_number": "859-259-2635",
            "fax_number": "859-254-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 VERSAILLES RD",
            "address_2": "SUITE 120",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405041796",
            "telephone_number": "859-259-2635",
            "fax_number": "859-254-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTISO",
        "first_name": "LORA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4380P",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3004380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100384290",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jefferson Franklin Musgrave, DPT
• Erika Nicole Music, MD
• Susan Kathleen Musilli, DO
• Lindsay Renee Musto, APRN
• Christine Muszynski, RBT
• Justyn Muzic, CRNA
• Jason Muzzillo, LCSW
• Valessa St. Pierre Mwanjawala, PSY.D.
• Grace Mwine, RBT
• My Vision Care Professional Limited Liability Company

• Psychiatric/Mental Health Nurse Practitioner in Lexington, KY
• Providers in Lexington, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; 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.