Individual provider Active NPI

Lisa Christine Withrow, APRN, NP-C

  • Family Nurse Practitioner
  • Bedford, NH
National Provider Identifier
1144453135
Registry record updated May 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
042349-23 Issued in NH
Practice address
116 S River Rd Unit D-2
Bedford, NH 03110
Phone
(603) 371-9402
Fax
(603) 371-9409
NPI assigned
Aug 25, 2009
Last updated
May 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2018

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 042349-23 NH Primary

Addresses

Primary practice location

116 S River Rd Unit D-2
Bedford, NH 03110

Mailing address

116 S River Rd Unit D-2
Bedford, NH 03110-6734
Phone (603) 371-9402

Other names 1

  • Lisa Christine Leblanc Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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

Enrollment IDStateProvider typePAC IDDetails
I20091216000258 NH Practitioner - Nurse Practitioner 6507906930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

116 S River Rd
Unit D2
Bedford, NH 03110-6734
Phone (603) 371-9402

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Palliativity Medical Group LLC CurrentSince Jan 11, 2015 Accepting new patients

Locations

116 S River Rd
Unit D2
Bedford, NH 03110
Phone (603) 371-9402

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526860800000",
    "number": "1144453135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 S RIVER RD UNIT D-2",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106734",
            "telephone_number": "603-371-9402",
            "fax_number": "603-371-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S RIVER RD UNIT D-2",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "03110",
            "telephone_number": "603-371-9402",
            "fax_number": "603-371-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHROW",
        "first_name": "LISA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-25",
        "last_updated": "2018-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "042349-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "LEBLANC",
            "middle_name": "CHRISTINE",
            "credential": "APRN, NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bedford, NH

Sources for this page

Verify at the official NPI Registry.