Mary Alyson Nijem Lerstang, NP

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

21011 Issued in SC

Practice address

312 Harrison Bridge Rd
Simpsonville, SC 29680-7133

Phone

(864) 603-5600

Fax

(864) 603-5601

NPI assigned

Jun 13, 2012

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 GA, SC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alyson.lerstang@valdostamed.gadirect.net

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.

• Valdosta Medical Clinic

  • Multi-Specialty Clinic/Center
  • Valdosta, GA
  • NPI 1538200035
  Medicare reassignment NPD

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1851653091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 HAWTHORNE PARK CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153194",
            "telephone_number": "864-603-5600",
            "fax_number": "864-603-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 HARRISON BRIDGE RD",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296807133",
            "telephone_number": "864-603-5600",
            "fax_number": "864-603-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERSTANG",
        "first_name": "MARY ALYSON",
        "middle_name": "NIJEM",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN155655",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "21011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Ann Drake Lee, PHARMD
• Terrell T Leeke, MD
• Holly Nichole Leickel, PT
• Katelyn Lemanski
• Vincent Leon Guerrero
• Julianne Leshinsky
• Phyllis Leverett, LPC
• Charlotte Levering, DPT
• Katherine Therese Lewis, M.D.
• Karen L Leyers, BSN

• Internal Medicine Physician in Simpsonville, SC
• Providers in Simpsonville, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.