Lisa Mickley, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101282278 Issued in VA

Practice address

725 Volvo Pkwy Ste 102
Chesapeake, VA 23320-1621

Phone

(757) 842-4110

NPI assigned

Mar 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Bayview Physician Services, PC

  • Family Medicine Physician
  • Chesapeake, VA
  • NPI 1508813387

  Pediatrics

  Medicare reassignment NPD
• Bayview Physician Services, PC

  • Radiology Clinic/Center
  • Suffolk, VA
  • NPI 1699865626
  NPD
• Bayview Medical Center, Inc

  • Ambulatory Surgical Clinic/Center
  • Suffolk, VA
  • NPI 1568466209
  NPD (past)
• Bayview Physician Services, PC

  • Clinical Medical Laboratory
  • Suffolk, VA
  • NPI 1629032339
  NPD (past)

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1831777291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7068",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237070068",
            "telephone_number": "757-686-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 VOLVO PKWY STE 102",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233201621",
            "telephone_number": "757-842-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKLEY",
        "first_name": "LISA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101282278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael S. Denbar, DDS
• Michael S. Weissman, PH.D.,LTD
• Claire Vanness Michaux, COTA/L
• Lakisha K Michel, COSMETOLOGIST
• Rachel Lynne Micheletti, LPC
• Mid Atlantic Dermatology
• Mid-Atlantic Homecare
• Mid-Atlantic Womens Care PLC
• Mid-Atlantic Womens Care PLC
• Mid-Atlantic Womens Care PLC

• Pediatrics Physician in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.