Provider Demographics
NPI:1619900206
Name:LESSARIS, KAREN JOYCE (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:JOYCE
Last Name:LESSARIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1305
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603
Mailing Address - Country:US
Mailing Address - Phone:828-345-0877
Mailing Address - Fax:828-345-0514
Practice Address - Street 1:352 2ND STREET, NW
Practice Address - Street 2:STE. 205
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601
Practice Address - Country:US
Practice Address - Phone:828-345-0877
Practice Address - Fax:828-345-0514
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000516208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89126HNMedicaid
SCN0051AMedicaid
NC1619900206Medicaid
NC126HNOtherNCBCBS
NC2298698AMedicare PIN
NC2182319AMedicare PIN
NC2298698Medicare PIN
NC126HNOtherNCBCBS