Individual provider Active NPI

Lexis Lavery Kretschmer

  • Nurse Practitioner
  • Clermont, FL
National Provider Identifier
1699459412
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11026904 Issued in FL
Practice address
2387 Garden Belle Dr
Clermont, FL 34711-9523
Phone
(352) 455-3993
NPI assigned
Jun 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 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 11026904 FL Primary

Addresses

Primary practice location

2387 Garden Belle Dr
Clermont, FL 34711-9523

Mailing address

2387 Garden Belle Dr
Clermont, FL 34711-9523
Phone (352) 455-3993

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20230908003393 TN Practitioner - Nurse Practitioner 6800250812 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34266TNMDPharmacist
11026904FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brookwell Health LLC Nurse Practitioner CurrentSince Sep 5, 2023 Accepting new patients
Brookwell Health LLC Past Accepting new patients

Locations

190D Saundersville Rd
Ste 4003
Hendersonville, TN 37075
Phone (866) 589-0003

709 Med Tech Pkwy
Ste 210
Johnson City, TN 37604
Phone (423) 427-2940

105 W Stone Dr
Kingsport, TN 37660
Phone (423) 307-5757

9314 Park West Blvd
Ste 102
Knoxville, TN 37923
Phone (423) 307-5757

2829 W Andrew Johnson Hwy
Morristown, TN 37814
Phone (423) 307-5757

Organizations & group practices 2

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": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1699459412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2387 GARDEN BELLE DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347119523",
            "telephone_number": "352-455-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2387 GARDEN BELLE DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347119523",
            "telephone_number": "352-455-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRETSCHMER",
        "first_name": "LEXIS",
        "middle_name": "LAVERY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11026904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.