Individual provider Active NPI

Lisa A Margraves

  • Clinical Social Worker
  • Georgetown, TX
National Provider Identifier
1124566336
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
39121 Issued in TX
Practice address
213 Sinuso Dr
Georgetown, TX 78628-1533
Phone
(512) 569-4017
NPI assigned
Feb 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 39121 TX Primary

Addresses

Primary practice location

213 Sinuso Dr
Georgetown, TX 78628-1533

Mailing address

213 Sinuso Dr Ste 235
Georgetown, TX 78628-1533
Phone (512) 569-4017

Other names 1

  • Lisa A Margraves Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190605001737 TX Practitioner - Clinical Social Worker 0244563377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

213 Sinuso Dr
Georgetown, TX 78628-1533
Phone (512) 569-4017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39121TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Revolutionary Wellness, PLLC Clinical CurrentSince Jun 1, 2019 Accepting new patients
St Davids Heart & Vascular, PLLC PastSince Jan 6, 2020 Accepting new patients

Locations

109 W 7th St
Ste 235
Georgetown, TX 78626

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1124566336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 SINUSO DR STE 235",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786281533",
            "telephone_number": "512-569-4017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 SINUSO DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786281533",
            "telephone_number": "512-569-4017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARGRAVES",
        "first_name": "LISA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "39121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "MARGRAVES",
            "middle_name": "A",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Georgetown, TX

Sources for this page

Verify at the official NPI Registry.