Active NPI
Lisa Nestor
- Community Health Worker
- South Charleston, WV
National Provider Identifier
1003409129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 3325 Trace Fork Rd
South Charleston, WV 25309-5120 - Phone
- (304) 744-0259
- NPI assigned
- Feb 19, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
3325 Trace Fork Rd
South Charleston, WV 25309-5120
Mailing address
3325 Trace Fork Rd
South Charleston, WV 25309-5120
Phone (304) 744-0259
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613692800000",
"number": "1003409129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3325 TRACE FORK RD",
"city": "SOUTH CHARLESTON",
"state": "WV",
"postal_code": "253095120",
"telephone_number": "304-744-0259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3325 TRACE FORK RD",
"city": "SOUTH CHARLESTON",
"state": "WV",
"postal_code": "253095120",
"telephone_number": "304-744-0259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NESTOR",
"first_name": "LISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-19",
"last_updated": "2021-02-19",
"certification_date": "2021-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.