LISA F DEJARNETTE (NPI# 1013994714) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013994714 |
| Entity Type | Individual |
| Full Name | LISA F DEJARNETTE |
| Credential | MD |
| Practice Address |
4420 Lake Boone Trail Raleigh NC 27607 |
| Practice Telephone | 9197847093 |
| Practice Fax Number | 9197847395 |
| Mailing Telephone | 9197847093 |
| Mailing Fax Number | 9197847395 |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2009-08-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 33640 | NC | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 33640 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 28339 | 01 | |
| NC | 8928339 | 05 | |
| DEA | BD1196383 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326383647 | Lisa R Dejarnette | Social Worker | 8040 Hosbrook Rd, Suite 320, Cincinnati, OH 45236-2901 | 2012-11-28 |
| Street Address |
4420 LAKE BOONE TRAIL |
| City | RALEIGH |
| State | NC |
| Zip Code | 27607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356976161 | Chelsea Kennedy Harris | Registered Nurse | 4420 Lake Boone Trail, Raleigh, NC 27607-7505 | 2020-03-12 |
| 1902159601 | Nathalie Kim | Nurse Anesthetist, Certified Registered | 4420 Lake Boone Trail, Raleigh, NC 27607-6599 | 2012-10-18 |
| 1609125095 | Elizabeth Beach Mcneely | Pharmacist | 4420 Lake Boone Trail, Rex Hospital Pharmacy Department, Raleigh, NC 27607 | 2012-08-31 |
| 1760775936 | Mary Brigid Farrell | Nurse Anesthetist, Certified Registered | 4420 Lake Boone Trail, Raleigh, NC 27616-2880 | 2011-05-22 |
| 1992011316 | Tiffany Kinton Carter | Registered Nurse | 4420 Lake Boone Trail, Raleigh, NC 27607-7505 | 2010-08-23 |
| 1376858910 | Jason Kaplan | Registered Nurse | 4420 Lake Boone Trail, Raleigh, NC 27607-7505 | 2010-08-06 |
| 1194058024 | Kimberly Townes Soden | Registered Nurse | 4420 Lake Boone Trail, Raleigh, NC 27607 | 2009-09-10 |
| 1386828754 | Nevin Mahendra Shrimanker | Anesthesiology | 4420 Lake Boone Trail, Critical Health Systems Office - Rex Hospital, Raleigh, NC 27607 | 2007-12-20 |
| 1174745665 | Jessica Lynn Henderson | Anesthesiology | 4420 Lake Boone Trail, Raleigh, NC 27607-2360 | 2007-05-03 |
| 1083836001 | Matthew Atkins | Anesthesiology | 4420 Lake Boone Trail, Rex Healthcare, Raleigh, NC 27607 | 2007-05-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972093144 | Kyndra Lawson | Behavior Technician | 5121 Kingdom Way, Suite 100, Raleigh, NC 27607 | 2018-05-14 |
| 1578082905 | Margaret Roberts Bova | Dietitian, Registered | 4207 Lake Boone Trail, Suite 210, Raleigh, NC 27607 | 2017-09-18 |
| 1184141897 | Chricat Garrard | Nurse Practitioner | 4207 Lake Boone Trl Ste 200, Raleigh, NC 27607 | 2017-08-23 |
| 1487178620 | John Patrick Morton | Pharmacist | 2411 Landmark Dr, Raleigh, NC 27607 | 2017-07-31 |
| 1023538857 | Heather Margaret Mazzola | Audiologist | 7800 Lake Boone Trail, 100, Raleigh, NC 27607 | 2017-06-22 |
| 1790216984 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2411 Landmark Drive, Raleigh, NC 27607 | 2017-03-21 |
| 1558819516 | Corilin Nocito Meggitt | Nurse Practitioner | 4505 Fair Meadows Ln Ste 102, Raleigh, NC 27607 | 2016-09-19 |
| 1942757034 | Stacie Walker | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 311, Raleigh, NC 27607 | 2016-09-06 |
| 1831644533 | Alisa Smajlagic Howe | Nurse Practitioner | 4210 Lake Boone Trail, Rex Rehab & Nursing Center, Raleigh, NC 27607 | 2016-08-23 |
| 1235598632 | Yoseph Saleh | Dentist | 107 Minden Ln, Raleigh, NC 27607 | 2016-02-15 |
| Find all providers in zip 27607 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053921874 | Wake Specialty Phisicians, LLC | Internal Medicine | 601 Oberlin Rd, Raleigh, NC 27605-1126 | 2020-08-06 |
| 1255825840 | Frederick Joseph Derosier | Internal Medicine | 1065 Tacketts Pond Dr, Raleigh, NC 27614-7887 | 2018-06-18 |
| 1023518412 | Neijia Grissom | Internal Medicine | 3214 Charles B Root Wynd Ste 213, Raleigh, NC 27612-5440 | 2018-02-13 |
| 1326406703 | Andrew Ubert Schindzielorz | Internal Medicine | 5300 Huntingwood Dr, Raleigh, NC 27606-9642 | 2016-02-01 |
| 1841680220 | Oswald H Ganley | Internal Medicine | 1251 Goode St, The Healing Place of Wake County, Raleigh, NC 27603 | 2015-01-23 |
| 1659775831 | Caremore Health Nc, PC | Internal Medicine | 1100 N Raleigh Blvd, Raleigh, NC 27610-1076 | 2014-10-16 |
| 1295147577 | Courtney Barrett | Internal Medicine | 6729 Falls of Neuse Rd Ste 100, Raleigh, NC 27615-5383 | 2014-05-21 |
| 1821357815 | Vanitha Gopal | Internal Medicine | 370 Allister Dr Unit 406, Raleigh, NC 27609-7269 | 2012-05-10 |
| 1093072498 | The Carter Clinic,pa | Internal Medicine | 183 Wind Chime Ct Ste 100, Raleigh, NC 27615-6574 | 2012-04-23 |
| 1497025076 | George Stueard Nettles Sr. | Internal Medicine | 11192 Bayberry Hills Dr, Raleigh, NC 27617-7908 | 2012-01-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.