Individual provider Active NPI

Scott Walker Lisson, MD

  • Urology Physician
  • Raleigh, NC
National Provider Identifier
1396726394
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2007-01720 Issued in NC
Practice address
3024 New Bern Ave
Raleigh, NC 27610-1247
Phone
(919) 350-7251
NPI assigned
Nov 8, 2005
Last updated
Mar 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2007-01720 NC Primary
Urology Physician 208800000X ME81837 FL

Addresses

Primary practice location

3024 New Bern Ave
Raleigh, NC 27610-1247

Mailing address

2920 Highwoods Blvd
Raleigh, NC 27604-0010
Phone (877) 498-4490

Other practice location 1

180 Foy Dr
Rocky Mount, NC 27804-2417
Phone (252) 443-3136

Other identifiers 3

IdentifierTypeStateIssuer
1396726394OtherBCBS NC
1396726394OtherNCRR MEDICARE
5909256MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address slisson53567@directHISP.wakemed.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20080707000581 NC Practitioner - Urology 9830261932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Boston University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians

Practice addresses (Care Compare)

222 Ashville Ave
Cary, NC 27518-6130
Phone (919) 859-1136

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME81837FLMDUrology Physician
2007-01720NCMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group LLC CurrentSince Aug 22, 2019 Accepting new patients
Wakemed Specialists Group LLC Urology CurrentSince Aug 22, 2019 Accepting new patients
Wakemed Specialists Group, LLC Urology Current Accepting new patients
Wake Specialty Physicians, LLC Urology PastSince Jan 5, 2014 Accepting new patients

Locations

210 Ashville Ave
Cary, NC 27518
Phone (919) 235-6460

222 Ashville Ave
Cary, NC 27518
Phone (919) 576-2330

400 US 70 Hwy E
Garner, NC 27529
Phone (919) 235-6400

101 Holly Creek Rd
Morrisville, NC 27560
Phone (919) 235-6480

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

10000 Falls of Neuse Rd
Ste 205
Raleigh, NC 27614
Phone (919) 350-1630

10010 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1380

23 Sunnybrook Rd
Raleigh, NC 27610
Phone (919) 350-6002

2920 Highwoods Blvd
Raleigh, NC 27604

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

3024 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-5318

1030 Siena Dr
Wake Forest, NC 27587
Phone (919) 235-6511

Interoperability endpoints

  • Direct secure messaging: scottlisson@rockymount.allscriptsdirect.net
  • Direct secure messaging: slisson53567@directhisp.wakemed.org

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, 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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1396726394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 HIGHWOODS BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276040010",
            "telephone_number": "877-498-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101247",
            "telephone_number": "919-350-7251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 Foy Dr",
            "address_purpose": "LOCATION",
            "city": "Rocky Mount",
            "state": "NC",
            "postal_code": "278042417",
            "country_code": "US",
            "telephone_number": "252-443-3136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LISSON",
        "first_name": "SCOTT",
        "middle_name": "WALKER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "2007-01720",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME81837",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "1396726394",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "1396726394",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5909256",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slisson53567@directHISP.wakemed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "XML",
            "address_1": "3024 New Bern Ave",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276101247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.