Jay Marlin Nissley, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD011004E Issued in PA

Practice address

55 Medical Park Dr
Lewisburg, PA 17837-6343

Phone

(570) 523-3264

Fax

(570) 523-3465

NPI assigned

Oct 4, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1215924345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MEDICAL PARK DR",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178376343",
            "telephone_number": "570-523-3264",
            "fax_number": "570-523-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MEDICAL PARK DR",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178376343",
            "telephone_number": "570-523-3264",
            "fax_number": "570-523-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISSLEY",
        "first_name": "JAY",
        "middle_name": "MARLIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD011004E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008831050003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Felicia Neidlinger
• Renee Neitz, PA-C
• Sonia Yvette Newton, M.D.
• Wendy K Nicholas, LSW
• Karen Byerly Nicholson
• Brendon R. Nolt, M.D.
• Ernest Y. Normington III, M.D.
• North Central Pennsylvania Dialysis Clinics-Lewisburg LLC
• Sharon A Novack, CRNA
• Brian Nungesser

• Pediatrics Physician in Lewisburg, PA
• Providers in Lewisburg, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.