Lisa Boyer Gatwood, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

855762 Issued in MS

Practice address

5192 Old Highway 11
Hattiesburg, MS 39402-6222

Phone

(601) 268-0929

Fax

(601) 261-0508

NPI assigned

Oct 13, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8276/brand/1/csg/1/fhir/r4
• Direct secure messaging: lgatwood26345@directpatientrecord.com

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.

• Hattiesburg Clinic PA

  • Multi-Specialty Clinic/Center
  • Hattiesburg, MS
  • NPI 1740213446
  Medicare reassignment Care Compare group NPD
• FGH Physician Billing

  • Cardiovascular Disease Physician
  • Hattiesburg, MS
  • NPI 1053469700
  Medicare reassignment NPD
• Pioneer Health Care , LLC

  • General Practice Physician
  • Bassfield, MS
  • NPI 1336384742
  Medicare reassignment NPD
• Hattiesburg Clinic, PA

  • Primary Care Clinic/Center
  • Flowood, MS
  • NPI 1912600354
  NPD
• Conx Care Corporation

  • Family Medicine Physician
  • Hattiesburg, MS
  • NPI 1548183510
  NPD (past)
• Hattiesburg Clinic, PA

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Laurel, MS
  • NPI 1245263540
  NPD (past)
• State of Mississippi - University of Mississippi Medical Center

  • Critical Access Hospital
  • Lexington, MS
  • NPI 1386630705
  NPD (past)

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

{
    "created_epoch": "1223856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1881846681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-268-0929",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5192 OLD HIGHWAY 11",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394026222",
            "telephone_number": "601-268-0929",
            "fax_number": "601-261-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATWOOD",
        "first_name": "LISA",
        "middle_name": "BOYER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-13",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R855762",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "855762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02123058",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgatwood26345@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "5192 Old Highway 11",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394026222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert Adam Gaston, DNP, CRNA
• Robert L Gaston, CRNA
• Gastrointestinal Associates, PA
• Dedrick Gates
• Karen Emily Gatlin, GNP-BC
• John Wells Gaudet, MD
• Cari Ann Gaunt, LPC
• Alex Gauthier
• Mona M Gauthier, LPC
• David Wayne Gavel, PHD

• Family Nurse Practitioner in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.