Individual provider Active NPI

Lisa Carol Kirk, CFNP

  • Family Nurse Practitioner
  • Morristown, TN
National Provider Identifier
1942314539
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN6552 Issued in TN
Practice address
350 E Economy Rd
Morristown, TN 37814-3327
Phone
(423) 318-6093
Fax
(423) 318-9326
NPI assigned
Aug 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN6552 TN Primary

Addresses

Primary practice location

350 E Economy Rd
Morristown, TN 37814-3327

Mailing address

484 Ashland Oaks Dr
Morristown, TN 37813-1067
Phone (423) 581-4619

Other identifiers 1

IdentifierTypeStateIssuer
3906306MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20060111000202 TN Practitioner - Nurse Practitioner 7113940602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

405 Scenic Dr
Suite B
Rogersville, TN 37857-2441
Phone (423) 272-2111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN6552TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince May 21, 2020 Accepting new patients
Blue Ridge Medical Mangement Corporation CurrentSince May 21, 2020 Accepting new patients
Wellmont Medical Associates Inc CurrentSince May 21, 2020 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince May 21, 2020 Accepting new patients

Locations

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

1744 E Andrew Johnson Hwy
Greeneville, TN 37745
Phone (423) 636-8891

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

405 Scenic Dr
Ste B
Rogersville, TN 37857
Phone (423) 272-2111

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942314539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 ASHLAND OAKS DR",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378131067",
            "telephone_number": "423-581-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E ECONOMY RD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378143327",
            "telephone_number": "423-318-6093",
            "fax_number": "423-318-9326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "LISA",
        "middle_name": "CAROL",
        "credential": "CFNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN6552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3906306",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

Verify at the official NPI Registry.