Claris Joanne Livingstone

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Mooresville, NC

NPI 1992321962 · NPPES record last updated Jun 9, 2022

Key facts

NPI
1992321962
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
5015959 (NC)
Practice address
122 Gateway Blvd Ste C
Mooresville, NC 28117-5544
Phone
(704) 360-3637
NPI assigned
Jun 24, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 6

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrative Wellness Solutions PLLC (143 clinicians)
Rebound Behavioral Health LLC (8 clinicians)

Practice addresses (Care Compare)

10620 Park Rd
Suite 208
Charlotte, NC 28210-0106
Phone (704) 360-3637

134 E Rebound Rd
Lancaster, SC 29720-7712
Phone (803) 313-3700

3625 N Elm St
Suite 130
Greensboro, NC 27455-2604
Phone (704) 360-3637

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in SC, NC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20200909000339 SC Practitioner - Nurse Practitioner 4688092661 Reassigns benefits to 2 organizations
I20220831003475 NC Practitioner - Nurse Practitioner 4688092661 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5015959NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rebound Behavioral Health, LLC Current
since Aug 1, 2020
Accepting new patients
Palmetto Medical Group, PLLC Current
since May 6, 2020
Accepting new patients
Constantrich Iic Psychiatric/Mental Health Current Accepting new patients
Palmetto Medical Group, PLLC Current
since May 6, 2020
Accepting new patients
Constantrich LLC Psychiatric/Mental Health Current Accepting new patients

Locations

1040 Edgewater Corporate Pkwy
Ste 101
Indian Land, SC 29707
Phone (803) 548-7007

134 E Rebound Rd
Lancaster, SC 29720
Phone (803) 313-3700

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.clarislivingstone@146232.advancedmd-direct.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 23271 SC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5015959 NC Yes

Addresses

Primary practice location

122 Gateway Blvd Ste C
Mooresville, NC 28117-5544

Mailing address

122 Gateway Blvd Ste C
Mooresville, NC 28117-5544
Phone (704) 360-3637

Other practice location 1

134 E Rebound Rd
Lancaster, SC 29720-7712
Phone (803) 313-3700 ext. 3732

Other practice location 2

1716 Craven Hill Dr
Rock Hill, SC 29730-3995
Phone (803) 367-2839

Other identifiers

IdentifierTypeStateIssuer
000000000000OtherSCNO NPI NUMBER AS YET

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address claris.livingstone@acadiahealthcare.com Health Information Exchange (HIE)
Direct Messaging Address claris.livingstone@acadiahealthcare.com Health Information Exchange (HIE)

Other providers in Mooresville, NC

All providers in Mooresville, NC · Psychiatric/Mental Health Nurse Practitioner in North Carolina

Sources for this page

Verify at the official NPI Registry.