Lisa J Hall, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110002089 Issued in VA

Practice address

1950 Glenn Mitchell
Suite 102
Virginia Beach, VA 23456-0019

Phone

(757) 368-0437

Fax

(757) 368-0492

NPI assigned

Jul 7, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Miss Lisa J Howe Former name

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Legacy Care Aco LLC

  • Family Medicine Physician
  • Virginia BCH, VA
  • NPI 1538844857
  Medicare reassignment
• Legacy Care LLC

  • Family Medicine Physician
  • Virginia Beach, VA
  • NPI 1902149776
  Medicare reassignment

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1356349047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 LAKE WRIGHT DR",
            "address_2": "SUITE 300",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235021871",
            "telephone_number": "757-213-5700",
            "fax_number": "757-213-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 GLENN MITCHELL",
            "address_2": "SUITE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560019",
            "telephone_number": "757-368-0437",
            "fax_number": "757-368-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "LISA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0101029566",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "10019259P",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "HOWE",
            "middle_name": "J",
            "prefix": "MISS",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hallie Hall, CSA
• James Scott Hall, RPH
• Janice Hall, CSAC-S
• Jenna Dawn Hall
• John Theodore Hall, R.PH.
• Marchele Hall
• Matthias J Hall, C.P.
• Michaela Lajoyceann Hall
• Robin Lynn Hall, LCSW
• Toshanna Hall

• Physician Assistant in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.