Active NPI
Lawrence Jebaneson Athisayanathan, FNP-C
- Family Nurse Practitioner
- Glen Allen, VA
National Provider Identifier
1033061544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 0024194806
- Practice address
- 11504 Sadler Walk LN
Glen Allen, VA 23060-6516 - Phone
- (804) 615-9796
- NPI assigned
- Feb 10, 2026
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024194806 | VA | Primary |
Addresses
Primary practice location
11504 Sadler Walk LN
Glen Allen, VA 23060-6516
Mailing address
11504 Sadler Walk LN
Glen Allen, VA 23060-6516
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024194806 | VA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1770681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770681600000",
"number": "1033061544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11504 SADLER WALK LN",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230606516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11504 SADLER WALK LN",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230606516",
"telephone_number": "804-615-9796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATHISAYANATHAN",
"first_name": "LAWRENCE",
"middle_name": "JEBANESON",
"credential": "FNP-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-02-10",
"last_updated": "2026-02-10",
"certification_date": "2026-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "VA",
"license": "0024194806",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Allen, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.