Individual provider Active NPI

Lissete Arias Whitaker

  • Infectious Disease Physician
  • Augusta, GA
National Provider Identifier
1205463114
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
105484 Issued in GA
Practice address
2050 Walton Way
Augusta, GA 30904-2305
Phone
(706) 434-1590
NPI assigned
Mar 23, 2020
Last updated
Aug 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Infectious Disease Physician 207RI0200X 105484 GA Primary

Addresses

Primary practice location

2050 Walton Way
Augusta, GA 30904-2305

Mailing address

1206 Arcilla PT
Martinez, GA 30907-9296
Phone (770) 757-8028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250820001265 GA Practitioner - Infectious Disease 9830559863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2050 Walton Way
Suite 101
Augusta, GA 30904-4163
Phone (706) 790-4440

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Improvement Project, Inc Single Specialty CurrentSince Aug 1, 2025 Accepting new patients
Neighborhood Improvement Project Inc CurrentSince Aug 1, 2025 Accepting new patients

Locations

2050 Walton Way
Augusta, GA 30904
Phone (706) 434-1590

2050 Walton Way
Ste 101
Augusta, GA 30904
Phone (706) 434-1590

2467 Golden Camp Rd
Augusta, GA 30906
Phone (706) 922-0682

Organizations & group practices 3

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 3

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": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1205463114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 ARCILLA PT",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309079296",
            "telephone_number": "770-757-8028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309042305",
            "telephone_number": "706-434-1590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "LISSETE",
        "middle_name": "ARIAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-23",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "GA",
            "license": "105484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.