Individual provider Active NPI

Lisa Terrance Lam, NP

  • Nurse Practitioner
  • Austin, TX
National Provider Identifier
1699120576
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5009829 Issued in NC
Practice address
4900 Mueller Blvd
Austin, TX 78723-3051
Phone
(512) 324-0000
NPI assigned
Apr 28, 2016
Last updated
Feb 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5009829 NC Primary

Addresses

Primary practice location

4900 Mueller Blvd
Austin, TX 78723-3051

Mailing address

4900 Mueller Blvd
Austin, TX 78723-3051
Phone (615) 579-3592

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181221002453 NC Practitioner - Nurse Practitioner 7911242763 Reassigns benefits to 2 organizations
I20230708000014 TX Practitioner - Nurse Practitioner 7911242763 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5009829NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children's Medical Group CurrentSince Mar 14, 2023 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Dell Children's Medical Group Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Sep 30, 2018 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Medical Center CurrentSince Sep 30, 2018 Accepting new patients
Dell Children's Medical Group CurrentSince Mar 14, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Sep 30, 2018 Accepting new patients
Carolinas Medical Center CurrentSince Sep 30, 2018 Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

7506 Pineleaf Pl
Ste 200
Austin, TX 78757

1000 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 628-1800

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1699120576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 MUELLER BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233051",
            "telephone_number": "615-579-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 MUELLER BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233051",
            "telephone_number": "512-324-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "LISA",
        "middle_name": "TERRANCE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-28",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5009829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.