Lisa Wilson- Jefferson

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Practice address

3854 Paper Birch LN
Lithonia, GA 30038-3342

Phone

(678) 480-5054

Fax

(888) 884-6471

NPI assigned

Sep 22, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Miss Lisa Marie Wilson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1497124291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3854 PAPER BIRCH LN",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300383342",
            "telephone_number": "678-480-5054",
            "fax_number": "888-884-6471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3854 PAPER BIRCH LN",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300383342",
            "telephone_number": "678-480-5054",
            "fax_number": "888-884-6471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON- JEFFERSON",
        "first_name": "LISA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-22",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "WILSON",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Olivia J, Williams, OTR/L
• Shonta Williams, LCSW
• Stacie Williams
• Walter Wendell Williams, MD
• Ivyonna Janiece Willis
• Bria Alexia Wilson
• Christie Wilson
• Eric Wilson, MD
• Julia Anne Wilson, M.D
• Kenya Wilson, RN

• In Home Supportive Care Agency in Lithonia, GA
• Providers in Lithonia, GA by specialty
• In Home Supportive Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.