Active NPI
Lisa Sue McCloud, FNP-BC
- Family Health Clinical Nurse Specialist
- Williamson, WV
National Provider Identifier
1780132571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Health Clinical Nurse Specialist
- License
- 61706
- Practice address
- 184 E 2ND Ave
Williamson, WV 25661-3602 - Phone
- (304) 235-2930
- Fax
- (304) 235-4202
- NPI assigned
- Sep 21, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Health Clinical Nurse Specialist | 364SF0001X | 61706 | WV | Primary |
Addresses
Primary practice location
184 E 2ND Ave
Williamson, WV 25661-3602
Mailing address
184 East 2ND Ave
Williamson, WV 25661
Phone (304) 235-2930
Other practice location 1
123 Enterprise Dr
Logan, WV 25601-3750
Phone (304) 752-0183
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2016009648 | Other | WV | ANCC CERTIFICATION # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161115002438 | WV | Practitioner - Nurse Practitioner | 5890074801 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Interoperability endpoints
- lmccloud20707@gohealthupmc.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726790400000",
"number": "1780132571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "184 EAST 2ND AVE",
"city": "WILLIAMSON",
"state": "WV",
"postal_code": "25661",
"telephone_number": "304-235-2930",
"fax_number": "304-235-4202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "184 E 2ND AVE",
"city": "WILLIAMSON",
"state": "WV",
"postal_code": "256613602",
"telephone_number": "304-235-2930",
"fax_number": "304-235-4202"
}
],
"practiceLocations": [
{
"address_1": "123 Enterprise Dr",
"address_purpose": "LOCATION",
"city": "Logan",
"state": "WV",
"postal_code": "256013750",
"country_code": "US",
"telephone_number": "304-752-0183",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCCLOUD",
"first_name": "LISA",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-21",
"last_updated": "2024-09-20",
"certification_date": "2024-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "364SF0001X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Family Health",
"state": "WV",
"license": "61706",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANCC CERTIFICATION #",
"identifier": "2016009648",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williamson, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.