NPIMap

Individual provider Active NPI

Lisa McIntosh Watson, FNP

  • Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1396807939
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
201617 Issued in NC
Practice address
1725 New Hanover Medical Park Dr
Wilmington, NC 28403-5345
Phone
(910) 662-9300
Fax
(910) 662-2401
NPI assigned
Dec 13, 2006
Last updated
Dec 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 201617 NC Primary

Addresses

Primary practice location

1725 New Hanover Medical Park Dr
Wilmington, NC 28403-5345

Mailing address

PO Box 936857
Atlanta, GA 31193-6857

Other names 1

  • Lisa Long Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Ambulatory@direct.carolinashealthcare.org Atrium Health

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
I20050714000712 NC Practitioner - Nurse Practitioner 0345276911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1814 New Hanover Medical Park Dr
Wilmington, NC 28403-5350
Phone (910) 662-8765

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NMG Health Services LLC CurrentSince May 1, 2021 Accepting new patients
Novant Health Medical Group Coastal Region, LLC CurrentSince May 1, 2021 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
Triangle Surgical Associates, P.a. PastSince Sep 30, 1996 Accepting new patients
Triangle Surgical Associates, P.a. Past Accepting new patients
Robert W Patterson MD PA Past Accepting new patients
Wilmington Health PLLC Past Accepting new patients
Novant Health New Hanover Regional Medical Center LLC Past Accepting new patients

Locations

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

1725 New Hanover Medical Park Dr
Wilmington, NC 28403
Phone (910) 662-9300

1814 New Hanover Medical Park Dr
Wilmington, NC 28403
Phone (910) 452-3666

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

Interoperability endpoints

  • Direct secure messaging: lwatson1253008@direct.novanthealth.org

Organizations & group practices 8

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 1

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1396807939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 NEW HANOVER MEDICAL PARK DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035345",
            "telephone_number": "910-662-9300",
            "fax_number": "910-662-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "LISA",
        "middle_name": "MCINTOSH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "201617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ambulatory@direct.carolinashealthcare.org",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1814 New Hanover Medical Park Dr",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284035350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "LONG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.