Lisa Gennosa, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-04811 Issued in NC

Practice address

504 N Main St
Robersonville, NC 27871-9567

Phone

(252) 795-5555

Fax

(252) 795-5566

NPI assigned

Feb 1, 2014

Last updated

Feb 1, 2014By 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

Enrolled in NC

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

Interoperability endpoints

• Direct secure messaging: gennosa.lisa.001.0330112@roph.meditab.direct-ci.com
• Direct secure messaging: gennosa.lisa.002.0330112@roph.meditab.direct-ci.com

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.

• Robersonville Physicians PC

  • Primary Care Clinic/Center
  • Robersonville, NC
  • NPI 1700075348
  Medicare reassignment

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

{
    "created_epoch": "1391212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391212800000",
    "number": "1457774028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 N MAIN ST",
            "city": "ROBERSONVILLE",
            "state": "NC",
            "postal_code": "278719567",
            "telephone_number": "252-795-5555",
            "fax_number": "252-795-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N MAIN ST",
            "city": "ROBERSONVILLE",
            "state": "NC",
            "postal_code": "278719567",
            "telephone_number": "252-795-5555",
            "fax_number": "252-795-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENNOSA",
        "first_name": "LISA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-01",
        "last_updated": "2014-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devotedlovehomeandservices
• Et-Al Transportation LLC
• Evelyn's Grace Haven
• First Step Home Care Service Inc
• First Step Home Care Services Inc
• Thomas Joseph Gennosa, MD
• Gloria Crandell-Nelson (Shadows Community Support Center)
• Cathy Griffin
• Healthfirst Wellness Center, PLLC
• Suzanne Williams Holland, FNP-C

• Physician Assistant in Robersonville, NC
• Providers in Robersonville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2014; 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.