NPIMap

Individual provider Active NPI

Lisa Ann Fedora, CRNP

  • Family Nurse Practitioner
  • Lancaster, PA
National Provider Identifier
1104899301
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP008664 Issued in PA
Practice address
1671 Crooked Oak Dr
Lancaster, PA 17601-4269
Phone
(717) 569-5331
Fax
(717) 569-5331
NPI assigned
Feb 8, 2006
Last updated
Jun 20, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP008664 PA Primary

Addresses

Primary practice location

1671 Crooked Oak Dr
Lancaster, PA 17601-4269

Mailing address

1671 Crooked Oak Dr
Lancaster, PA 17601-4269
Phone (717) 569-5331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20060124000011 PA Practitioner - Nurse Practitioner 5890719355 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lancaster General Medical GroupGroup PAC ID 0941103683, 590 clinicians

Practice addresses (Care Compare)

1671 Crooked Oak Dr
Lancaster, PA 17601-4269
Phone (717) 569-5331

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP008664PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster General Medical Group CurrentSince Nov 30, 2020 Accepting new patients
Reading Professional Services CurrentSince Sep 15, 2014 Accepting new patients
Tower Health Medical Group Current Accepting new patients
Lancaster General Medical Group CurrentSince Nov 30, 2020 Accepting new patients
Tower Health Medical Group CurrentSince Sep 15, 2014 Accepting new patients
Lancaster General Medical Group Current Accepting new patients
Mercy Neurosurgery Group Past Accepting new patients
Lancaster General Medical Group Past Accepting new patients

Locations

1671 Crooked Oak Dr
Lancaster, PA 17601
Phone (717) 569-5331

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

554 N Duke St
Lancaster, PA 17602
Phone (717) 291-5863

1701 Cornwall Rd
Lebanon, PA 17042
Phone (717) 675-1750

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

601 Spruce St
West Reading, PA 19611
Phone (484) 628-8900

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

Interoperability endpoints

  • Direct secure messaging: lfedora207709@direct-lghealth.org

Organizations & group practices 8

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 8

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1104899301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1671 CROOKED OAK DR",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176014269",
            "telephone_number": "717-569-5331",
            "fax_number": "717-569-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1671 CROOKED OAK DR",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176014269",
            "telephone_number": "717-569-5331",
            "fax_number": "717-569-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDORA",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP008664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.