Lisa Jo Matherson, CRNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

SPOO3533H Issued in PA

Practice address

2050 Old West Chester Pike
Havertown, PA 19083-2712

Phone

(610) 449-8600

Fax

(610) 449-1302

NPI assigned

May 14, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Geps Physician Group of Pennsylvania PC

  • Internal Medicine Physician
  • Kennett Square, PA
  • NPI 1467471615

  Gerontology

  Medicare reassignment NPD
• Alignmed Medical Group, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Baltimore, MD
  • NPI 1366289423

  PA

  Medicare reassignment
• Alignmed Partners, PC

  dba GPS Physician Group PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Gardendale, AL
  • NPI 1881109452

  PA

  Medicare reassignment
• Geps Physician Group of Pennsylvania, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Avondale, AZ
  • NPI 1851774897
  NPD
• Scott a. Fleischer, M.D., P.C.

  • Psychiatry Physician
  • Fort Washington, PA
  • NPI 1720181720
  NPD (past)

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922213594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 GREEN HOLLOW RD",
            "city": "GLENMOORE",
            "state": "PA",
            "postal_code": "193431509",
            "telephone_number": "610-913-8008",
            "fax_number": "610-913-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 OLD WEST CHESTER PIKE",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832712",
            "telephone_number": "610-449-8600",
            "fax_number": "610-449-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHERSON",
        "first_name": "LISA",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SPOO3533H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robyn Martin, MS
• Gina Marie Martinelli Noble, MPT, ATC
• Marianne Bernadette Martino, PSY. D.
• Amberleigh Martucci
• Melissa Matamoros, B.A
• Dana Matheson
• Marielle Martino Mathews, PSYD
• Courtney Ann Matthews, B.S.L.
• Tierra Matthews, RN
• Luke Francis Mattson, PHARMD

• Gerontology Nurse Practitioner in Havertown, PA
• Providers in Havertown, PA by specialty
• Gerontology Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.