Active NPI
Lisa Michelle Wilson, M.D.
- Family Medicine Physician
- Roxboro, NC
National Provider Identifier
1689638892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 200201023
- Practice address
- 3762 Durham Rd
Suite B
Roxboro, NC 27573-2741 - Phone
- (336) 322-1024
- Fax
- (336) 322-1022
- NPI assigned
- Apr 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 200201023 | NC | Primary |
Addresses
Primary practice location
3762 Durham Rd
Suite B
Roxboro, NC 27573-2741
Mailing address
PO Box 561
Roxboro, NC 27573-0561
Phone (336) 322-1024
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5903537 | Medicaid | NC | |
| N0102A | Medicaid | SC |
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081031000339 | NC | Practitioner - Family Practice | 4688605280 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200201023 | NC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DLP Person Physician Practices LLC | Current | Accepting new patients | |
| DLP Person Physician Practices, LLC | Family Medicine | Current | Accepting new patients |
Locations
3762 Durham Rd
#B
Roxboro, NC 27573
Phone (336) 322-1024
601 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699
Interoperability endpoints
- lisa.wilson.1@20247.direct.athenahealth.com
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Roxboro, NC
- NPI 1548544802
Family Medicine, NC
-
- Surgery Physician
- Roxboro, NC
- NPI 1891287520
Hospital & facility affiliations 11
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Durham, NC
- NPI 1083669873
-
- Home Health Agency
- Roxboro, NC
- NPI 1982963294
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Medical College of Ohio, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- DLP Person Physician Practices LLC
Practice addresses (Care Compare)
3762 Durham Rd
Suite B
Roxboro, NC 27573-2741
Phone (336) 322-1024
601 Ridge Rd
Roxboro, NC 27573-4629
Phone (336) 599-5754
615 Ridge Rd
Roxboro, NC 27573-4629
Phone (336) 322-4040
Hospital & facility affiliations
- Amedisys Home Health
- Bayada Home Health Care, Inc
- Person Memorial Hospital
- Duke University Hospital
- Duke Regional Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376265600000",
"number": "1689638892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 561",
"city": "ROXBORO",
"state": "NC",
"postal_code": "275730561",
"telephone_number": "336-322-1024",
"fax_number": "336-322-1022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3762 DURHAM RD",
"address_2": "SUITE B",
"city": "ROXBORO",
"state": "NC",
"postal_code": "275732741",
"telephone_number": "336-322-1024",
"fax_number": "336-322-1022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "LISA",
"middle_name": "MICHELLE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-14",
"last_updated": "2013-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "200201023",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5903537",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "N0102A",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roxboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.