Individual provider Active NPI

Lisa M Trautman, APRN PMHNP-BC, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Port St Joe, FL
National Provider Identifier
1861987604
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11033104 Issued in FL
Practice address
2475 Garrison Ave
Port St Joe, FL 32456-5265
Phone
(850) 227-9220
NPI assigned
Jun 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11033104 FL Primary
Family Nurse Practitioner 363LF0000X 11033104 FL

Addresses

Primary practice location

2475 Garrison Ave
Port St Joe, FL 32456-5265

Mailing address

2475 Garrison Ave
Port St Joe, FL 32456-5265
Phone (850) 227-9220

Other practice location 1

1940 Harrison Ave
Panama City, FL 32405-4542
Phone (850) 763-0017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, SC, FL3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20201028002491 IL Practitioner - Nurse Practitioner 8820408008 Reassigns benefits to 1 organization
I20210923003395 SC Practitioner - Nurse Practitioner 8820408008 Reassigns benefits to 1 organization
I20260515003484 FL Practitioner - Nurse Practitioner 8820408008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Medical Associates of the Medical University of South Carol 1,634 clinicians

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

Hospital & facility affiliations

  • Musc Medical Center Hospital, Charleston, SC, CCN 420004

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.017845ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol CurrentSince Sep 9, 2021 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Sep 9, 2021 Accepting new patients
Main St. Psychiatry, S.C. CurrentSince Sep 15, 2020 Accepting new patients
Lawrence L. Kerns, M.D. & Associates Past Accepting new patients

Locations

10 W Main St
Ste 101
Cary, IL 60013
Phone (815) 526-3781

5911 N West Hwy
Ste 207
Crystal Lake, IL 60014
Phone (815) 455-7400

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Interoperability endpoints

  • Direct secure messaging: ltrautman371835@direct.musc.edu

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1861987604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 GARRISON AVE",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324565265",
            "telephone_number": "850-227-9220",
            "fax_number": "850-807-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 GARRISON AVE",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324565265",
            "telephone_number": "850-227-9220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1940 Harrison Ave",
            "address_purpose": "LOCATION",
            "city": "Panama City",
            "state": "FL",
            "postal_code": "324054542",
            "country_code": "US",
            "telephone_number": "850-763-0017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAUTMAN",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "APRN PMHNP-BC, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11033104",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11033104",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Joe, FL

Sources for this page

Verify at the official NPI Registry.