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Lisa Kathryn Smith

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

225 Baldwin Ave, Charlotte, NC 28204-3109

PECOS Enrollment

This provider is enrolled in PECOS as LISA SMITH.

Based on the most recent information from CMS, provider Lisa Kathryn Smith is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:59 PM.

Profile Details

Provider ID
1699300350
Provider Type
Individual
Full Name
Smith, Lisa Kathryn
Credential
MSN, APRN, NP-C

Gender
Female
Sole Proprietor
No
Enumeration Date
3/3/2020
Last Updated
8/6/2025

Contact Information

Practice Location

225 Baldwin Ave, Charlotte, NC 28204-3109

(704) 376-1605

(704) 335-8448

Mailing Location

225 Baldwin Ave, Charlotte, NC 28204-3109

(704) 376-1605

(704) 335-8448

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 5013879 North Carolina
Code 163W00000X	Description Registered Nurse Nursing Service Providers	License RN-268083 North Carolina

Lisa Kathryn Smith

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Meyran, Kimberly H

Harrold, Dena

Buttriss, Grace O.

Mccann, Alexandra Kwasny

Wrenn, Megan Mcdonald

Smith, Julie Trust

Cummins, Jessica Rae

Palmer, Scott Mikael

Blair-Rutherford, Kristie Lynn

Norman, Emma Paige