Lisa R. Davidavage, CRNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

SP011092 Issued in PA

Practice address

2500 Bernville Rd
Reading, PA 19605-9453

Phone

(610) 378-2000

Fax

(610) 378-2799

NPI assigned

Apr 13, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Joseph Medical GroupGroup PAC ID 3779688650, 190 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Penn State Health St. Joseph Hospital, Reading, PA, CCN 390096

Merit-based Incentive Payment System (MIPS)

Final score

79.31 of 100Reported as group

Quality

55.01

Promoting interoperability

99

Improvement activities

40

Cost

76.86

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• St. Joseph Medical Group

  • Family Medicine Physician
  • Reading, PA
  • NPI 1184754657
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Regional Health Network

  • General Acute Care Hospital
  • Reading, PA
  • NPI 1699734665
  Care Compare affiliation

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

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1710277686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 BERNVILLE RD",
            "city": "READING",
            "state": "PA",
            "postal_code": "196059453",
            "telephone_number": "610-378-2000",
            "fax_number": "610-378-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 BERNVILLE RD",
            "city": "READING",
            "state": "PA",
            "postal_code": "196059453",
            "telephone_number": "610-378-2000",
            "fax_number": "610-378-2799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 Keystone Blvd",
            "address_purpose": "LOCATION",
            "city": "Pottsville",
            "state": "PA",
            "postal_code": "179018982",
            "country_code": "US",
            "telephone_number": "570-544-1633",
            "fax_number": "570-544-1695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDAVAGE",
        "first_name": "LISA",
        "middle_name": "R.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-13",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP011092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "570-544-1633",
            "affiliation": "N",
            "endpointDescription": "health center phone number",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1201 Keystone Blvd",
            "city": "Pottsville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "179018982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Daniel & Max, LLC
• Samantha Jean Darrow
• Niladri Das, MD
• David H. Foster O.D.
• David H. Foster O.D.
• Bethany Taylor Davidheiser, PA-C
• Prunella Mary Davidson, MA
• Cherise R Davies
• Alexandra Davis, PA-C
• Carlina Davis

• Acute Care Nurse Practitioner in Reading, PA
• Providers in Reading, PA by specialty
• Acute Care Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; 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.

Verify at the official NPI Registry.