Individual provider Active NPI

Lisa Vialva, RN

  • Registered Nurse
  • Atlanta, GA
National Provider Identifier
1730768235
Registry record updated Apr 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN256886 Issued in GA
Practice address
1400 Tullie Rd NE Ste 630
Atlanta, GA 30329-2309
Phone
(404) 633-4398
NPI assigned
Apr 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN256886 GA Primary

Addresses

Primary practice location

1400 Tullie Rd NE Ste 630
Atlanta, GA 30329-2309

Mailing address

1400 Tullie Rd NE Ste 630
Atlanta, GA 30329-2309
Phone (404) 633-4398

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20250303001289 GA Practitioner - Nurse Practitioner 5395266761 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN256886GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Medcura Health, Inc. CurrentSince Feb 24, 2025 Accepting new patients
Medcura Health, Inc. CurrentSince Feb 24, 2025 Accepting new patients
Medcura Health, Inc. Current Accepting new patients
Medcura Health, Inc. Past Accepting new patients

Locations

5582 Memorial Dr
Stone Mountain, GA 30083
Phone (404) 513-9965

770 Village Square Dr
Stone Mtn, GA 30083
Phone (404) 298-7658

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": "1617408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617408000000",
    "number": "1730768235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 TULLIE RD NE STE 630",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292309",
            "telephone_number": "404-633-4398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 TULLIE RD NE STE 630",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292309",
            "telephone_number": "404-633-4398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIALVA",
        "first_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-03",
        "last_updated": "2021-04-03",
        "certification_date": "2021-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN256886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.