Joyce Lynn Lea, DO
Individual provider Active NPI Family Medicine Physician · Carrollton, VA
NPI 1720041205 · NPPES record last updated Jan 2, 2013
Key facts
- NPI
- 1720041205
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 0102049953 (VA)
- Practice address
- 13609 Carrollton Blvd
Suite 11
Carrollton, VA 23314-3214 - Phone
- (757) 238-8751
- Fax
- (757) 238-8750
- NPI assigned
- Apr 7, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VA, NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061120000478 | VA | Practitioner - Family Practice | 7315945656 | Reassigns benefits to 1 organization |
| I20200604002893 | NC | Practitioner - Family Practice | 7315945656 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102049953 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Immaculate Hospital LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0102049953 | VA | Yes |
Addresses
Primary practice location
13609 Carrollton Blvd
Suite 11
Carrollton, VA 23314-3214
Mailing address
7007 Harbour View Blvd
Suite 108
Suffolk, VA 23435-2719
Phone (757) 215-2745
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5600677 | Medicaid | VA |
Other providers in Carrollton, VA
- Tara Jones
- James Albert Jowdy
- Jesse Stephens Julian Jr.
- Lisa Marie Knust
- David Kucher
- Jennifer J Lewis
- Meng Liu
- Bartholomew Michael Lopresti
- Donna Marchant-Roof
- Maryview Hospital
All providers in Carrollton, VA · Family Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 2, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.