Lisa Edwards

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

35564 Issued in WV

Practice address

5447 Maple LN Ste a
Fayetteville, WV 25840-6872

Phone

(304) 573-6120

NPI assigned

Feb 16, 2024

Last updated

Feb 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Amedisys Home Health

  • Home Health Agency
  • Fayetteville, WV
  • NPI 1891488896
  NPD Authorized official

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1710742911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5447 MAPLE LN STE A",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "258406872",
            "telephone_number": "304-573-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5447 MAPLE LN STE A",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "258406872",
            "telephone_number": "304-573-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WV",
            "license": "35564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Delung
• Amy Demoss
• Alicia Kay Dempsey, PHARMD, RPH
• Hailey Pet Dinehart
• Heidi E Dolin, FNP
• Roni Fair
• Patsy J Fairchild, PA-C
• Family Medical Kare
• Family Vision Care Inc
• Chloe A Farris

• Licensed Practical Nurse in Fayetteville, WV
• Providers in Fayetteville, WV by specialty
• Licensed Practical Nurse in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; 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.