Individual provider Active NPI

Wesley F Lister-Winebrenner, PA-C

  • Physician Assistant
  • Birmingham, AL
National Provider Identifier
1659326478
Registry record updated Mar 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA920 Issued in TN
Practice address
3940 Montclair Road
Suite 410
Birmingham, AL 35213-2421
Phone
(205) 879-7066
Fax
(205) 871-5066
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X PA920 TN
Physician Assistant 363A00000X PA920 TN Primary
Surgical Physician Assistant 363AS0400X 842 AL

Addresses

Primary practice location

3940 Montclair Road
Suite 410
Birmingham, AL 35213-2421

Mailing address

3940 Montclair Road
Suite 410
Birmingham, AL 35213-2421
Phone (205) 879-5066

Other names 1

  • Wesley F Lister Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA920TNMDPhysician Assistant
842ALMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Julian M. Thomas M.D. Past Accepting new patients
Health Star North Inc PastSince Oct 6, 2019 Accepting new patients
Knoxville Dermatology Group PC Dermatology PastSince Feb 1, 2018 Accepting new patients
Dermatology Associates of Knoxville, PC Dermatology Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1659326478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3940 MONTCLAIR ROAD",
            "address_2": "SUITE 410",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352132421",
            "telephone_number": "205-879-5066",
            "fax_number": "205-871-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3940 MONTCLAIR ROAD",
            "address_2": "SUITE 410",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352132421",
            "telephone_number": "205-879-7066",
            "fax_number": "205-871-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISTER-WINEBRENNER",
        "first_name": "WESLEY",
        "middle_name": "F",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "PA920",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA920",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "842",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WESLEY",
            "last_name": "LISTER",
            "middle_name": "F",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; 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.