Tenesa Stokes Lightsey, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN209799 Issued in GA

Practice address

9201 E Mountain View Rd Ste 220
Scottsdale, AZ 85258-5172

Phone

(877) 564-3627

Fax

(480) 907-2646

NPI assigned

Aug 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vidalia Immediate and Primary Care LLCGroup PAC ID 8820489941, 10 clinicians

Wayne SJC Medical Group LLCGroup PAC ID 5496901811, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GICFDD/Endpoint/GICFDD
• FHIR API: https://fhir4.healow.com/fhir/r4/GDDICA
• FHIR API: https://fhir4.healow.com/fhir/r4/GICFDD
• FHIR API: https://fhir4.healow.com/fhir/r4/GDDICA/Endpoint/GDDICA

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• McKinney Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Alma, GA
  • NPI 1134454911

  Corporate Director

  CMS ownership
• McKinney Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Nahunta, GA
  • NPI 1871756049

  Corporate Director

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vidalia Immediate & Primary Care LLC

  • Primary Care Clinic/Center
  • Vidalia, GA
  • NPI 1942974167
  Medicare reassignment Care Compare group NPD
• Wayne SJC Medical Group, LLC

  • Otolaryngology Physician
  • Jesup, GA
  • NPI 1538421177
  Medicare reassignment Care Compare group NPD
• Wayne SJC Medical Group, LLC

  • Orthopaedic Surgery Physician
  • Jesup, GA
  • NPI 1851730626
  NPD
• Cardiovascular Associates of Eastern Georgia

  • Specialist
  • Statesboro, GA
  • NPI 1518902147
  NPD (past)

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1033837760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 RHETT CIR",
            "city": "PATTERSON",
            "state": "GA",
            "postal_code": "315572452",
            "telephone_number": "912-614-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 E MOUNTAIN VIEW RD STE 220",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585172",
            "telephone_number": "877-564-3627",
            "fax_number": "480-907-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTSEY",
        "first_name": "TENESA",
        "middle_name": "STOKES",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN209799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "information",
            "affiliation": "N",
            "address_1": "9201 E Mountain View Rd Ste 220",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852585172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Janelle Liffiton, RN BSN
• Light Source Caregivers, LLC
• Lighthouse Center Inc.
• Lighthouse Counseling and Psychotherapy PLLC
• Lighthouse Psychology LLC
• Robert David Ligorsky, D.O.
• Jordan Liles
• Sean T Lille, MD
• Joseph L Lillo, DO, FNLA, FAPCR
• Mandy Lim, D.O.

• Family Nurse Practitioner in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.