Active NPI
Lisa Corinne Sofocleous, CNP
- Nurse Practitioner
- Columbus, OH
National Provider Identifier
1790325660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN.CNP.025876
- Practice address
- 250 Brodbelt LN Apt 204
Columbus, OH 43215-2458 - Phone
- (330) 540-7636
- NPI assigned
- Jan 8, 2020
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN.CNP.025876 | OH | Primary |
Addresses
Primary practice location
250 Brodbelt LN Apt 204
Columbus, OH 43215-2458
Mailing address
250 Brodbelt LN Apt 204
Columbus, OH 43215-2458
Phone (330) 540-7636
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| APRN.CNP.025876 | Other | OH | OHIO BOARD OF NURSING |
| F08190884 | Other | OH | OHIO BOARD OF NURSING |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN.CNP.025876 | OH | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578441600000",
"number": "1790325660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 BRODBELT LN APT 204",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432152458",
"telephone_number": "330-540-7636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 BRODBELT LN APT 204",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432152458",
"telephone_number": "330-540-7636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOFOCLEOUS",
"first_name": "LISA",
"middle_name": "CORINNE",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-08",
"last_updated": "2020-01-08",
"certification_date": "2020-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "APRN.CNP.025876",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO BOARD OF NURSING",
"identifier": "APRN.CNP.025876",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO BOARD OF NURSING",
"identifier": "F08190884",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.