Individual provider Active NPI

Lissette Kinsella, FNP

  • Family Nurse Practitioner
  • Palmyra, VA
National Provider Identifier
1609204569
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024171375 Issued in VA
Practice address
77 Market St Ste E
Palmyra, VA 22963-4687
Phone
(434) 589-9030
Fax
(434) 589-9040
NPI assigned
Oct 30, 2013
Last updated
Jul 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024171375 VA Primary

Addresses

Primary practice location

77 Market St Ste E
Palmyra, VA 22963-4687

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007

Other practice location 1

33 Rebecca Dr
Palmyra, VA 22963-6242
Phone (434) 654-4680

Other names 1

  • Lissette Estella Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lkinsella8816@direct.healthsystem.virginia.edu Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140618001218 VA Practitioner - Nurse Practitioner 5496979205 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

77 Market St
Suite E
Palmyra, VA 22963-4687
Phone (434) 589-9030

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024171375VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Jan 19, 2016 Accepting new patients
University of Virginia Physicians Group CurrentSince Jan 4, 2021 Accepting new patients
Privia Medical Group, LLC CurrentSince Jan 19, 2016 Accepting new patients
Martha Jefferson Hospital PastSince May 28, 2017 Accepting new patients

Locations

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

3025 Berkmar Dr
Charlottesvle, VA 22901
Phone (434) 973-1831

3025 Berkmar Dr
Ste 1
Charlottesvle, VA 22901
Phone (434) 973-1831

8644 Sudley Rd
#220
Manassas, VA 20110

77 Market St
Ste E
Palmyra, VA 22963
Phone (434) 589-9030

7605 Forest Ave
Ste 316
Richmond, VA 23229
Phone (804) 282-0044

Interoperability endpoints

  • Direct secure messaging: lkinsella8816@direct.healthsystem.virginia.edu

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 5

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": "1383091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1609204569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 MARKET ST STE E",
            "city": "PALMYRA",
            "state": "VA",
            "postal_code": "229634687",
            "telephone_number": "434-589-9030",
            "fax_number": "434-589-9040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 Rebecca Dr",
            "address_purpose": "LOCATION",
            "city": "Palmyra",
            "state": "VA",
            "postal_code": "229636242",
            "country_code": "US",
            "telephone_number": "434-654-4680",
            "fax_number": "434-589-6688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINSELLA",
        "first_name": "LISSETTE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-30",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024171375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lkinsella8816@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "77 Market St Ste E",
            "city": "Palmyra",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229634687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LISSETTE",
            "last_name": "ESTELLA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Palmyra, VA

Sources for this page

Verify at the official NPI Registry.