NPIMap

Individual provider Active NPI

Lisa A Duggan, PA-C

  • Medical Physician Assistant
  • Dahlgren, VA
National Provider Identifier
1093789364
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110002252 Issued in VA
Practice address
16463 Dahlgren Rd
Dahlgren, VA 22448
Phone
(540) 644-9505
Fax
(540) 644-9508
NPI assigned
Feb 14, 2006
Last updated
Oct 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110002252 VA Primary

Addresses

Primary practice location

16463 Dahlgren Rd
Dahlgren, VA 22448

Mailing address

PO Box 1460
Fredericksburg, VA 22402-1460
Phone (540) 786-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060509000789 VA Practitioner - Physician Assistant 0648281345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-1100

3310 Fall Hill Ave
Fredericksburg, VA 22401-3000
Phone (540) 373-4602

7851 Dolleys CT
King George, VA 22485-7085
Phone (540) 644-9505

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Physicians CurrentSince Sep 18, 2018 Accepting new patients
Mary Washington Healthcare Physicians CurrentSince Sep 18, 2018 Accepting new patients
King George Medical Center LTD PastSince Apr 1, 2006 Accepting new patients
Medidoctors Primary Care LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

2632 Salem Church Rd
Fredericksburg, VA 22407
Phone (540) 899-3430

16463 Dahlgren Rd
King George, VA 22485
Phone (540) 644-9505

7851 Dolleys Ct
King George, VA 22485
Phone (540) 220-8629

8051 Prosperity Way
Ste 100
Ruther Glen, VA 22546
Phone (804) 448-0198

Interoperability endpoints

  • Direct secure messaging: lduggan36718@marywashingtonhealthcare.direct-ci.com

Organizations & group practices 5

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

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1093789364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1460",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224021460",
            "telephone_number": "540-786-2100",
            "fax_number": "540-786-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16463 DAHLGREN RD",
            "city": "DAHLGREN",
            "state": "VA",
            "postal_code": "22448",
            "telephone_number": "540-644-9505",
            "fax_number": "540-644-9508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGGAN",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110002252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dahlgren, VA

Sources for this page

Verify at the official NPI Registry.