Active NPI
Lisa Van Wie, RN
- Gastroenterology Physician
- Albany, NY
National Provider Identifier
1184383267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 462362
- Practice address
- 1375 Washington Ave Ste 201
Albany, NY 12206-1056 - Phone
- (518) 533-3420
- NPI assigned
- Dec 15, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 462362 | NY | Primary |
Addresses
Primary practice location
1375 Washington Ave Ste 201
Albany, NY 12206-1056
Mailing address
1375 Washington Ave Ste 201
Albany, NY 12206-1056
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 462362 | NY | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639526400000",
"number": "1184383267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1375 WASHINGTON AVE STE 201",
"city": "ALBANY",
"state": "NY",
"postal_code": "122061056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1375 WASHINGTON AVE STE 201",
"city": "ALBANY",
"state": "NY",
"postal_code": "122061056",
"telephone_number": "518-533-3420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN WIE",
"first_name": "LISA",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-15",
"last_updated": "2021-12-15",
"certification_date": "2021-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NY",
"license": "462362",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.