Lisa Marie Wangberg, FNP/DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024185593 Issued in VA

Practice address

1505 Franklin Rd SW
Roanoke, VA 24016-5206

Phone

(540) 343-7331

Fax

(540) 343-7349

NPI assigned

Nov 14, 2022

Last updated

Nov 14, 2022By 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 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

Medicare enrollment (NPD)

Enrolled

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.

• Allergy & Immunology, PLC

  dba Asthma & Allergy Center

  • Allergy & Immunology Physician
  • Roanoke, VA
  • NPI 1457423550
  Medicare reassignment NPD
• Allergy & Immunology VA, LLC

  dba Asthma & Allergy Center

  • Allergy & Immunology Physician
  • Roanoke, VA
  • NPI 1609707488
  NPD (past)

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1962110429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 VALLEYWOOD DR",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245512809",
            "telephone_number": "907-775-2407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240165206",
            "telephone_number": "540-343-7331",
            "fax_number": "540-343-7349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANGBERG",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "FNP/DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-14",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024185593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Keith Walters, PHARMD
• David Clark Walton, M.D.
• Benjamin Bin Wang, O.D.
• Kenten Pey-Kuen Wang, D.O.
• Yunan Wang, M.D.
• Lubna B. Wani, M.D.
• Gretchen Elizabeth Ann Waninger
• Lee Wann, RPH
• Andrew A Ward, MD
• Brian Scott Ward, DDS

• Family Nurse Practitioner in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.