DR. DWIGHT H LYSNE (NPI# 1083679062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083679062 |
| Entity Type | Individual |
| Full Name | DR. DWIGHT H LYSNE |
| Credential | MD, MDIV |
| Practice Address |
20 S 16th St Wilmington NC 28401-4924 |
| Mailing Address |
7212 Oyster Ln Wilmington NC 28411-7132 |
| Practice Telephone | 8774566729 |
| Practice Fax Number | 9103993928 |
| Mailing Telephone | 9104651935 |
| Mailing Fax Number | 9103993928 |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2012-09-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
200301378 | NC | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
28290 | MN | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
5512 | ND | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 15992 | 05 | |
| ND | NDBCBS | 19977 | 01 |
| RAILROAD MEDICARE | 260045000 | 01 | |
| NC | 891378J | 05 | |
| MN | 937078100 | 05 | |
| MN | MNBC/BS | 94D78LY | 01 |
| Street Address |
20 S 16TH ST |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28401-4924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831571447 | Dawn Lysne | Family Medicine | 20 S 16th St, Wilmington, NC 28401-4924 | 2015-06-19 |
| 1184055436 | Haven | Psychiatry & Neurology | 20 S 16th St, Wilmington, NC 28401-4924 | 2013-12-11 |
| 1285862292 | Haven | Psychiatry & Neurology | 20 S 16th St, Wilmington, NC 28401-4924 | 2009-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275002461 | Thrivetothrive, LLC | Physical Therapist | 1606 Physicians Drive, Inside Promina Health, Wilmington, NC 28401 | 2018-11-16 |
| 1841787454 | Kevin Christopher Panebianco | Family Medicine | 1911 S 17th St Ste 130a, Wilmington, NC 28401 | 2018-04-18 |
| 1518472588 | Michelle Bruin | Family Medicine | 415 S. 2nd Street, Wilmington, NC 28401 | 2017-12-12 |
| 1639617343 | Anna Farwell | Behavior Technician | 3904 Oleander Dr. Suite 102, Wilmington, NC 28401 | 2017-02-02 |
| 1588034144 | Dimitri Zivko Pitovski | Allergy & Immunology | 1099 Medical Center Dr Unit 100b, Wilmington, NC 28401 | 2015-09-25 |
| 1629457007 | Megan Havel | Counselor | 1512 E Lakeshore Drive, Wilmington, NC 28401 | 2015-05-19 |
| 1154709251 | Lance Hutchens | Dentist | 1611 Doctors Cir, Wilmington, NC 28401 | 2015-05-11 |
| 1609281161 | Diane Pittman Whitford | Counselor | 313 Walnut St., Wilmington, NC 28401 | 2014-06-24 |
| 1942550728 | Bryan Cole Chalk | Nurse Anesthetist, Certified Registered | 2131 S 17th Street, Wilmington, NC 28401 | 2012-09-19 |
| 1740566546 | Valerie Baars | Pharmacist | 2302 S 17th Street, Wilmington, NC 28401 | 2011-10-25 |
| Find all providers in zip 28401 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861705956 | Haven Ministries, Inc. | Psychiatry & Neurology | 3725b Wrightsville Ave, Wilmington, NC 28403-4140 | 2010-07-19 |
| 1902046832 | Yadvinder K Sandhu | Psychiatry & Neurology | 3229 S College Rd, Wilmington, NC 28412-6740 | 2009-03-05 |
| 1811192065 | Maria Annette Mccarthy | Psychiatry & Neurology | 501 W 14th St Ste 1e40, Wilmington, DE 19801-1013 | 2007-06-18 |
| 1467502773 | Imran Trimzi | Psychiatry & Neurology | 5163 W Woodmill Dr Ste 13, Wilmington, DE 19808-4067 | 2007-01-11 |
| 1205442688 | Saurabh Gupta Md LLC | Psychiatry & Neurology | 410 Foulk Rd Ste 106, Wilmington, DE 19803-3835 | 2020-09-21 |
| 1093200479 | Allison Taylor Dovi | Psychiatry & Neurology | 1600 Rockland Rd, Wilmington, DE 19803-3607 | 2018-06-27 |
| 1063943371 | Jenine Weber | Psychiatry & Neurology | 825 N Washington St, Wilmington, DE 19801-1509 | 2017-03-27 |
| 1326306267 | Zachariah D. Pranckun | Psychiatry & Neurology | 1600 Rockland Rd, Wilmington, DE 19803-3607 | 2012-04-29 |
| 1942568142 | Amanda Cassel Castro | Psychiatry & Neurology | 1600 Rockland Rd, Wilmington, DE 19803-3607 | 2012-04-25 |
| 1164735254 | Haven Ministries, Inc. @ Agape | Psychiatry & Neurology | 3725b Wrightsville Ave, Wilmington, NC 28403-4140 | 2010-07-19 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 28401 |
Please comment or provide details below to improve the information on DR. DWIGHT H LYSNE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.