NPIMap

Individual provider Active NPI

Lisa Ann Deisch, PA-C

  • Physician Assistant
  • Fayetteville, NC
National Provider Identifier
1316653892
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-13059 Issued in NC
Practice address
1340 Walter Reed Rd Ste 202
Fayetteville, NC 28304-4451
Phone
(910) 504-3506
NPI assigned
Jan 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X NC
Physician Assistant 363A00000X 0010-13059 NC Primary

Addresses

Primary practice location

1340 Walter Reed Rd Ste 202
Fayetteville, NC 28304-4451

Mailing address

1725 Real Quiet PL
Hope Mills, NC 28348-8097
Phone (910) 284-2118

Other practice location 1

1219 Walter Reed Rd
Fayetteville, NC 28304-4437
Phone (910) 615-3350

Other practice location 2

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-3350

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230426001783 NC Practitioner - Physician Assistant 1052776044 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 672-0350

4140 Ferncreek Dr
Suite 801
Fayetteville, NC 28314-2572
Phone (910) 484-2171

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Fear Valley Health Medical Group LLC CurrentSince Mar 15, 2025 Accepting new patients
Cape Fear Valley Health Medical Group LLC CurrentSince Mar 15, 2025 Accepting new patients
Cape Fear Valley Health Medical Group LLC Physician Assistant Past Accepting new patients

Locations

1219 Walter Reed Rd
Fayetteville, NC 28304
Phone (910) 609-5000

4140 Ferncreek Dr
Ste 801
Fayetteville, NC 28314
Phone (910) 484-2171

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

Interoperability endpoints

  • Direct secure messaging: ldeisch93756@capefearvalley.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1674777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1316653892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 REAL QUIET PL",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283488097",
            "telephone_number": "910-284-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 WALTER REED RD STE 202",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044451",
            "telephone_number": "910-504-3506"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1219 Walter Reed Rd",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283044437",
            "country_code": "US",
            "telephone_number": "910-615-3350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1638 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043424",
            "country_code": "US",
            "telephone_number": "910-615-3350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEISCH",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-27",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.