Individual provider Active NPI

Emily Lieser, CPNP-PC

  • Primary Care Nurse Practitioner
  • Pace, FL
National Provider Identifier
1831577956
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN9325675 Issued in FL
Practice address
5565 Woodbine Rd
Pace, FL 32571
Phone
(850) 994-5010
NPI assigned
May 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN9325675 FL Primary
Pediatric Nurse Practitioner 363LP0200X ARNP 9325675 FL

Addresses

Primary practice location

5565 Woodbine Rd
Pace, FL 32571

Mailing address

PO Box 2699
Pensacola, FL 32513-2699
Phone (850) 475-4686

Other practice location 1

3074 Killarney Dr
Pace, FL 32571-8430
Phone (864) 704-2964

Other identifiers 1

IdentifierTypeStateIssuer
014991300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 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
I20150707000438 FL Practitioner - Nurse Practitioner 1557673423 Reassigns benefits to 1 organization
I20221229000140 AL Practitioner - Nurse Practitioner 1557673423 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 9325675FLMDPediatric Nurse Practitioner
APRN9325675FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. Current Accepting new patients
Cep America, LLC CurrentSince Mar 13, 2024 Accepting new patients
Children's Urgent Care, LLC CurrentSince Nov 14, 2022 Accepting new patients
Cep America LLC CurrentSince Mar 13, 2024 Accepting new patients

Locations

500 Cahaba Park Cir
Ste 100
Birmingham, AL 35242
Phone (205) 848-2273

117 N Chalkville Rd
Trussville, AL 35173
Phone (205) 848-2273

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

Interoperability endpoints

  • Direct secure messaging: emily.lieser.1@9582.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1831577956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-475-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5565 WOODBINE RD",
            "city": "PACE",
            "state": "FL",
            "postal_code": "32571",
            "telephone_number": "850-994-5010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3074 Killarney Dr",
            "address_purpose": "LOCATION",
            "city": "Pace",
            "state": "FL",
            "postal_code": "325718430",
            "country_code": "US",
            "telephone_number": "864-704-2964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIESER",
        "first_name": "EMILY",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-08",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN9325675",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP 9325675",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014991300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pace, FL

Sources for this page

Verify at the official NPI Registry.