Individual provider Active NPI

Lisa Marie Jessee, FNP

  • Family Nurse Practitioner
  • Weber City, VA
National Provider Identifier
1891011235
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024168750 Issued in VA
Practice address
1754 US Highway 23 N
Weber City, VA 24290-7071
Phone
(276) 386-5980
Fax
(276) 386-9387
NPI assigned
Apr 9, 2010
Last updated
Aug 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024168750 VA
Family Nurse Practitioner 363LF0000X 0024168750 VA Primary

Addresses

Primary practice location

1754 US Highway 23 N
Weber City, VA 24290-7071

Mailing address

PO Box 9
Kingsport, TN 37662-0009
Phone (423) 857-2066

Other identifiers 2

IdentifierTypeStateIssuer
1520727MedicaidTN
1891011235MedicaidVA

Other names 1

  • Lisa Marie Lundy Former name

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100505000115 VA Practitioner - Nurse Practitioner 5193853653 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024168750VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Holston Medical Group PC Nurse Practitioner CurrentSince Apr 5, 2010 Accepting new patients

Locations

121 Advanced Technology Dr
Duffield, VA 24244
Phone (276) 431-2648

495 E Main St
Lebanon, VA 24266
Phone (276) 889-3700

1754 US Highway 23 North
Weber City, VA 24290
Phone (276) 386-5980

Interoperability endpoints

  • Direct secure messaging: lisalundy@hmgpath.allscriptsdirect.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1270771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1891011235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376620009",
            "telephone_number": "423-857-2066",
            "fax_number": "423-857-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1754 US HIGHWAY 23 N",
            "city": "WEBER CITY",
            "state": "VA",
            "postal_code": "242907071",
            "telephone_number": "276-386-5980",
            "fax_number": "276-386-9387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSEE",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-09",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024168750",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024168750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1520727",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891011235",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "LUNDY",
            "middle_name": "MARIE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Weber City, VA

Sources for this page

Verify at the official NPI Registry.