Lisa Gail Sidebotham, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

93836 Issued in NC

Practice address

2615 Elmhurst Dr
Fayetteville, NC 28304-5336

Phone

(917) 900-2296

NPI assigned

Oct 7, 2026

Last updated

Oct 7, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1791331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1275437543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 ELMHURST DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283045336",
            "telephone_number": "917-900-2296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 ELMHURST DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283045336",
            "telephone_number": "917-900-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDEBOTHAM",
        "first_name": "LISA",
        "middle_name": "GAIL",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-10-07",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NC",
            "license": "93836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda M Shultz, OTRL
• April Ann Shumard
• Lindsay K Shumate, FNP-BC
• Joseph L Shurtleff, DDS
• Hunnain Siddiqui, PHARMD
• Stacie A Sidebotham, FNP
• Deborah Jean Sides, NP
• Kellsie Rae Siebach, LMFT
• Kate Sifuentes
• Sightsee Optometry, PLLC

• Licensed Practical Nurse in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Licensed Practical Nurse in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; 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.