Individual provider Active NPI

Meaghan Rathvon Lisman, RN-C, FNP-BC

  • Family Nurse Practitioner
  • Harrisburg, PA
National Provider Identifier
1790915775
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP139719 Issued in TX
Practice address
121 N Nyes Rd
Suite F
Harrisburg, PA 17112-3247
Phone
(717) 214-6545
Fax
(717) 531-0639
NPI assigned
Jul 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP139719 TX Primary
Family Nurse Practitioner 363LF0000X SP012598 PA

Addresses

Primary practice location

121 N Nyes Rd
Suite F
Harrisburg, PA 17112-3247

Mailing address

2512 S Interstate 35
Ste 310
Austin, TX 78704-5758
Phone (512) 900-5844

Other names 1

  • Meaghan Kelly Rathvon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190416001598 TX Practitioner - Nurse Practitioner 4981730918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VMD Primary Providers of South Central Texas PLLCGroup PAC ID 7911337472, 27 clinicians

Practice addresses (Care Compare)

720 W 34TH St
Suite 100
Austin, TX 78705-1241
Phone (512) 988-5355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP139719TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
VMD Primary Providers of South Central Texas PLLC CurrentSince Feb 1, 2023 Accepting new patients
Remedy Clinics of Texas PA PastSince Dec 29, 2019 Accepting new patients

Locations

720 W 34th St
Ste 100
Austin, TX 78705
Phone (512) 381-5599

9055 Katy Fwy
Ste 200
Houston, TX 77024
Phone (346) 980-2701

799 Louis Henna Blvd
#7310
Round Rock, TX 78664

Interoperability endpoints

  • Direct secure messaging: meaghan.lisman.1@13711.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.

NPI Registry JSON

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

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1790915775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 S INTERSTATE 35",
            "address_2": "STE 310",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787045758",
            "telephone_number": "512-900-5844",
            "fax_number": "844-965-9421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N NYES RD",
            "address_2": "SUITE F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171123247",
            "telephone_number": "717-214-6545",
            "fax_number": "717-531-0639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISMAN",
        "first_name": "MEAGHAN",
        "middle_name": "RATHVON",
        "credential": "RN-C, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-23",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139719",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP012598",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEAGHAN",
            "last_name": "RATHVON",
            "middle_name": "KELLY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.