Lidee of Aesthetics and Gynecology, PC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

101037944 Issued in VA

Legal business name

LIDEE OF AESTHETICS AND GYNECOLOGY, PC

Practice address

1992 Medical Ave
Harrisonburg, VA 22801-3436

Phone

(540) 437-1296

Fax

(540) 437-1298

NPI assigned

Jun 6, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Sherry L Braithwaite

Title

Office Manager

Phone

(540) 437-1296

Specialties & licenses 2

Addresses

Other identifiers 8

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rebecca Botticelli, M.D.

  • Family Medicine Physician
  • Harrisonburg, VA
  • NPI 1053307074
  NPD (past)
• Hunter Marlo, D.O.

  • Family Medicine Physician
  • Harrisonburg, VA
  • NPI 1477716959
  NPD (past)
• Karen S Martin, WHNP

  • Women's Health Nurse Practitioner
  • Fishersville, VA
  • NPI 1558490714
  NPD (past)
• Julie A. Thurnau, R.D.

  • Registered Dietitian
  • Harrisonburg, VA
  • NPI 1285827147
  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366070400000",
    "number": "1144269002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1992 MEDICAL AVE",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228013436",
            "telephone_number": "540-437-1296",
            "fax_number": "540-437-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1992 MEDICAL AVE",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228013436",
            "telephone_number": "540-437-1296",
            "fax_number": "540-437-1298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIDEE OF AESTHETICS AND GYNECOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2013-04-16",
        "status": "A",
        "authorized_official_last_name": "BRAITHWAITE",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "540-437-1296",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "101054345",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "VA",
            "license": "101037944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR CAMPER CIGNA",
            "identifier": "541480016005",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR MARLO NPI",
            "identifier": "1477716959",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN-DR CAMPER",
            "identifier": "P00341994",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1477716959",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICAL PTAN GROUP",
            "identifier": "DF1466",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR CAMPER MAMSI",
            "identifier": "2129961",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR CAMPER ANTHEM PROVIDER",
            "identifier": "144250",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR CAMPER SOUTHERN HEALTH",
            "identifier": "243253",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert C Li, MD
• Amy Burgess Liberace, PA-C
• Val Joseph Liberace, M.D.
• Nicole Lichtenwalner, MS, LAT, ATC, CEAS I
• Jason Lichti, LPC
• Brandon Lien
• Jeffrey K. Lightner, MD
• Lightwell Counseling, PLLC
• Mackenzie Lilley
• Xiaofan Lin

• Gynecology Physician in Harrisonburg, VA
• Providers in Harrisonburg, VA by specialty
• Gynecology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.