Lisa Marie Wannamaker, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

55462 Issued in GA

Practice address

4720 Washington Rd
Evans, GA 30809

Phone

(706) 774-7263

NPI assigned

Dec 14, 2006

Last updated

Jun 4, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CIDHCD
• FHIR API: https://fhir4.healow.com/fhir/r4/HIBHCD

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.

• University Medical Group LLC

  • Internal Medicine Physician
  • Augusta, GA
  • NPI 1336413954

  Family Medicine

  NPD
• University Medical Group LLC

  • Internal Medicine Physician
  • Augusta, GA
  • NPI 1871885806

  Family Medicine

  NPD
• University Primary Care

  • Internal Medicine Physician
  • Augusta, GA
  • NPI 1124231808
  NPD
• Hernando Pasco Primary Care LLC

  dba MyCare Medical

  • Internal Medicine Physician
  • Lutz, FL
  • NPI 1245273093

  Family Medicine

  NPD (past)
• University Health Services, Inc.

  dba University Home Health North Augusta

  • Home Health Agency
  • North Augusta, SC
  • NPI 1457309676
  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1912069451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1705",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309031705",
            "telephone_number": "706-774-7263",
            "fax_number": "706-774-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 WASHINGTON RD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "30809",
            "telephone_number": "706-774-7263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Branch Ct",
            "address_purpose": "LOCATION",
            "city": "Grovetown",
            "state": "GA",
            "postal_code": "308133325",
            "country_code": "US",
            "telephone_number": "706-396-3570",
            "fax_number": "706-396-3590",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4446 Washington Rd Ste 7",
            "address_purpose": "LOCATION",
            "city": "Evans",
            "state": "GA",
            "postal_code": "308096361",
            "country_code": "US",
            "telephone_number": "706-650-3173",
            "fax_number": "706-863-5233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "447 N Belair Rd",
            "address_purpose": "LOCATION",
            "city": "Evans",
            "state": "GA",
            "postal_code": "308093090",
            "country_code": "US",
            "telephone_number": "706-854-2180",
            "fax_number": "706-854-2189",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "465 N Belair Rd Ste 2B",
            "address_purpose": "LOCATION",
            "city": "Evans",
            "state": "GA",
            "postal_code": "308093190",
            "country_code": "US",
            "telephone_number": "706-774-7400",
            "fax_number": "706-774-7590",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3486 Peach Orchard Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309065215",
            "country_code": "US",
            "telephone_number": "706-828-8000",
            "fax_number": "706-828-8001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANNAMAKER",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "55462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett Wallentine, MD
• Adam David Waller, M.D.
• Amy Walsh
• Alexander Dominique Walters
• Elayne Wang, DDS
• Jennifer Ward, D.O.
• Stephen Paul Warren, NP-C
• Teresa Annette Watts, DNP, FNP-C
• Adrian Todd Weaver, D.M.D.
• Steven Webb

• Family Medicine Physician in Evans, GA
• Providers in Evans, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; 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.