Individual provider Active NPI

Lisa Ann Walker Bigelow, RN, MSN

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Media, PA
National Provider Identifier
1033105077
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
RN318709L Issued in PA
Practice address
107 Chesley Dr
Media, PA 19063-1760
Phone
(610) 891-9024
Fax
(610) 891-9699
NPI assigned
Sep 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X CNS000330 PA
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X RN318709L PA Primary

Addresses

Primary practice location

107 Chesley Dr
Media, PA 19063-1760

Mailing address

107 Chesley Dr
Media, PA 19063-1760
Phone (610) 891-9024

Other practice location 1

100 Maris Grove Way
Glen Mills, PA 19342-1282
Phone (610) 387-4520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150211001437 PA Practitioner - Certified Clinical Nurse Specialist (CNS) 8628393865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
CNS000330PAMDClinical Nurse Specialist
RN318709LPAMDPsychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1033105077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 CHESLEY DR",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190631760",
            "telephone_number": "610-891-9024",
            "fax_number": "610-891-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CHESLEY DR",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190631760",
            "telephone_number": "610-891-9024",
            "fax_number": "610-891-9699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Maris Grove Way",
            "address_purpose": "LOCATION",
            "city": "Glen Mills",
            "state": "PA",
            "postal_code": "193421282",
            "country_code": "US",
            "telephone_number": "610-387-4520",
            "fax_number": "610-387-4526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER BIGELOW",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "PA",
            "license": "CNS000330",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "PA",
            "license": "RN318709L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.