LISA CAMILLE PRUITT RICHARDS (NPI# 1023257615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023257615 |
| Entity Type | Individual |
| Full Name | LISA CAMILLE PRUITT RICHARDS |
| Credential | PA-C |
| Practice Address |
2544 Court Dr Ste A Gastonia NC 28054-3450 |
| Mailing Address |
4601 Park Rd Suite 300 Charlotte NC 28209-3239 |
| Practice Telephone | 7046716400 |
| Practice Fax Number | 7046716449 |
| Mailing Telephone | (704) 323-2000 |
| Enumeration Date | 2009-02-05 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0010-01622 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1023257615 | 05 | |
| NC | BCBS | 1654F | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 710 Park Center Dr, Suite 300, Matthews, NC 281055012 | 7043232000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589348 | Lisa Joy Richards | Family Medicine | 4578 N Biscayne Dr, North Port, FL 34291-7081 | 2020-08-24 |
| 1497304141 | Lisa Richards | Licensed Practical Nurse | 29205 132nd Ave Se, Auburn, WA 98092-2142 | 2019-09-05 |
| 1831546316 | Lisa Marie Richards | Psychologist | 423 Old Mill Rd, Beckley, WV 25801-9557 | 2016-05-16 |
| 1013139492 | Lisa Anne Richards | Dentist | 4699 Hamann Pkwy, Willoughby, OH 44094-5631 | 2007-05-03 |
| 1639155732 | Lisa E Richards | Physician Assistant | 700 W 5th St, Clare, MI 48617-9414 | 2005-12-20 |
| 1457750143 | Lisa Richards | Student in an Organized Health Care Education/Training Program | 890 Hayes St, San Francisco, CA 94117-2615 | 2014-08-19 |
| 1669881249 | Lisa Marie Richards | Nurse Practitioner | 2100 W Central Ave, Toledo, OH 43606-3800 | 2014-08-07 |
| 1487073672 | Lisa Richards | Massage Therapist | 2002 London Rd, Suite 94, Duluth, MN 55812-2144 | 2014-04-15 |
| 1487932661 | Lisa R Richards | Counselor | 10537 S Roberts Rd, Palos Hills, IL 60465-1933 | 2011-07-22 |
| 1609163690 | Lisa Anne Richards | Physical Therapist | 2748 Colonial Dr, Suite A, Helena, MT 59601-4947 | 2011-06-29 |
| Street Address |
2544 COURT DR STE A |
| City | GASTONIA |
| State | NC |
| Zip Code | 28054-3450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962531921 | Kimberly Denise Clay | Internal Medicine | 2544 Court Dr Ste A, Gastonia, NC 28054-3450 | 2007-03-05 |
| 1366973372 | Miriam W. Holcomb | Nurse Practitioner | 2544 Court Dr Ste A, Gastonia, NC 28054-3450 | 2017-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671423 | Michaela Karsyn Morris | Behavioral Analyst | 2875 Court Dr. B, Gastonia, NC 28054 | 2019-10-21 |
| 1982263810 | Brenda Sue Fox | Occupational Therapist | Brian Center, 969 Cox Rd, Gastonia, NC 28054 | 2019-06-13 |
| 1174096911 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 469 Hospital Drive, Suite B1, Gastonia, NC 28054 | 2019-01-04 |
| 1255801817 | Jarae Mcswain | Counselor | 1558 Union Road, Ste F, Gastonia, NC 28054 | 2018-11-27 |
| 1427549807 | Alterman & Dhillon Charlotte Metro, Pplc | Dentist | 2205 E. Franklin Blvd, Ste 110, Gastonia, NC 28054 | 2018-05-22 |
| 1871083147 | Terrence Lamont Campbell | Dentist | 2641 Court Dr Ste A, Gastonia, NC 28054 | 2018-05-13 |
| 1861995367 | Jefferson and Jefferson LLC. | Respite Care | 945 East 6 Ave, Gastonia, NC 28054 | 2018-03-12 |
| 1790154912 | Tyler Adcock | Pharmacist | 2324 South New Hope Rd, Gastonia, NC 28054 | 2015-09-17 |
| 1922481894 | Alesha Nicole Logan | Nurse Practitioner | 1895 Hoffman Rd Ste A, Gastonia, NC 28054 | 2015-07-09 |
| 1457732596 | Buffie Baker Eller | Counselor | 2005 Flint Lane, Gastonia, NC 28054 | 2015-06-15 |
| Find all providers in zip 28054 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154889996 | Chad William Ellis | Physician Assistant | 620 Summit Crossing Pl Ste 202, Gastonia, NC 28054-2176 | 2019-03-12 |
| 1669846200 | Kathryn Carol O'neil | Physician Assistant | 3302 S New Hope Rd Ste 100b, Gastonia, NC 28056 | 2015-11-19 |
| 1861528408 | Sharon K Danello | Physician Assistant | 2682 Court Dr Ste B, Gastonia, NC 28054-1442 | 2007-02-26 |
| 1427152479 | Lisa Smith Veale Boone | Physician Assistant | 2555 Court Dr Ste 120, Gastonia, NC 28054-2177 | 2006-09-12 |
| 1497862155 | William Carlton Cabaniss Jr. | Physician Assistant | 1554 Union Rd Ste C, Gastonia, NC 28054-5581 | 2006-08-25 |
| 1609832591 | Mark Alexander Efird | Physician Assistant | 311 W 3rd Ave, Gastonia, NC 28052-4057 | 2006-04-21 |
| 1891758876 | Jennifer A. Drovie | Physician Assistant | 900 Cox Rd, Suite A, Gastonia, NC 28054-3460 | 2006-04-10 |
| 1841260270 | Anne Klugo-fetting | Physician Assistant | 631 Cox Rd, Gastonia, NC 28054-3438 | 2006-01-26 |
| 1295715795 | Geoffrey Lance Hardin | Physician Assistant | 2610 Aberdeen Blvd, Gastonia, NC 28054-0637 | 2006-01-19 |
| 1912984949 | David L James | Physician Assistant | 3670 S New Hope Rd, Suite A1 and A2, Gastonia, NC 28056-8395 | 2005-12-30 |
| Find all providers in GASTONIA | ||||
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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.