LISBON MEDICAL GROUP (NPI# 1871780379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871780379 |
| Entity Type | Organization |
| Organization Name | LISBON MEDICAL GROUP |
| Other Organization Name | LISBON HEALTH CLINIC |
| Practice Address |
7016 Cty Rt 10 Lisbon NY 13658-0176 |
| Mailing Address |
Po Box 176 7016 Cty Rt 10 Lisbon NY 13658-0176 |
| Practice Telephone | 3153933227 |
| Practice Fax Number | 3153931322 |
| Mailing Telephone | 3153933227 |
| Mailing Fax Number | 3153931322 |
| Enumeration Date | 2007-09-28 |
| Last Update Date | 2007-09-28 |
| Authorized Official Name | MR. ALAN J WINNEY (PHYSICIAN ASSISTANT) |
| Authorized Official Telephone | 3153933227 |
| Authorized Official Credential | PA |
| Is Organization Subpart | Y |
| Parent Organization Name | LISBON MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 000374 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00637903 | 05 |
| Other Name | Type Code |
|---|---|
| Lisbon Health Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740611425 | Lisbon Medical Group | Clinical Nurse Specialist | 7016 County Route 10, Lisbon, NY 13658-0176 | 2013-12-06 |
| Street Address |
7016 CTY RT 10 |
| City | LISBON |
| State | NY |
| Zip Code | 13658-0176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639514565 | Ernie S Cougler | Registered Nurse | 7016 County Route 10, Lisbon, NY 13658 | 2013-05-06 |
| 1598946378 | Barbara Ann Mcbath | Licensed Practical Nurse | 77 Maple Island Rd, Lisbon, NY 13658 | 2007-11-20 |
| 1942348982 | Lisbon Central School | Local Education Agency (LEA) | 6866 Cr 10, Lisbon, NY 13658-0039 | 2007-02-02 |
| 1740611425 | Lisbon Medical Group | Clinical Nurse Specialist | 7016 County Route 10, Lisbon, NY 13658-0176 | 2013-12-06 |
| 1316093974 | Dawn M Fields | Licensed Practical Nurse | 208 Dezell Rd, Lisbon, NY 13658-3105 | 2007-01-26 |
| 1073016572 | Jennifer Lynn Cole-warriner | Behavioral Analyst | 386 Murphy Rd, Lisbon, NY 13658-3175 | 2018-03-12 |
| 1922203850 | Terri Simzer | Physical Therapist | 125 Keyes Rd, Lisbon, NY 13658-3204 | 2007-06-20 |
| 1720100233 | Jean Russo | Licensed Practical Nurse | 71 Keyes Rd, Lisbon, NY 13658-3204 | 2007-04-04 |
| 1194809194 | Salvatore Micheal Puleo | Counselor | 10589 State Highway 37, Lisbon, NY 13658-3250 | 2006-10-25 |
| 1235304577 | John Schuyler Gammon II | Massage Therapist | 488 Bull Run Rd, Lisbon, NY 13658-3257 | 2008-04-28 |
| Find all providers in zip 13658 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174946438 | Jennifer Griffith | Physician Assistant | 8730 Scroggs Rd, Lisbon, OH 44432-9333 | 2014-01-22 |
| 1225013634 | Katie L Tanner | Physician Assistant | 819 Main St, Lisbon, ND 58054-4244 | 2005-12-08 |
| 1619288305 | Brent Michael Buchholz | Physician Assistant | 905 Main St, Lisbon, ND 58054-4334 | 2010-06-28 |
| 1265470371 | Bruce D Larson | Physician Assistant | 819 Main St, Lisbon, ND 58054-4244 | 2006-06-02 |
| 1801868062 | Stacey Maria Walton | Physician Assistant | 10 9th Ave E, Lisbon, ND 58054-4738 | 2006-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821026 | Victoria Yunaev | Physician Assistant | 7203 166th St, Fresh Meadows, NY 11365-3237 | 2020-11-05 |
| 1811598857 | Brittany Christine Androsko | Physician Assistant | 1769 Union St Fl 2, Niskayuna, NY 12309-6311 | 2020-11-05 |
| 1164023172 | Betina Charlotte Apostol Nuguid | Physician Assistant | 1730 Central Park Ave Ste 3p, Yonkers, NY 10710-4905 | 2020-11-05 |
| 1023619129 | Anna Leigh Vonck | Physician Assistant | 2 Executive Park Dr Ste 2, Albany, NY 12203-3700 | 2020-11-04 |
| 1952902256 | Billy Phuoctan Truong | Physician Assistant | 8832 18th Ave, Brooklyn, NY 11214-6002 | 2020-11-03 |
| 1205437621 | Jason Patrick Feak | Physician Assistant | 6338 Falls Blvd, Chittenango, NY 13037-8799 | 2020-11-03 |
| 1437750742 | Drew James Mitchell | Physician Assistant | 58 Old Bedford Rd, Goldens Bridge, NY 10526-1000 | 2020-11-03 |
| 1306446125 | Julie Mcphillips | Physician Assistant | 961 W Kaisertown Rd, Montgomery, NY 12549-2317 | 2020-10-30 |
| 1487254330 | Thomas J Nagel | Physician Assistant | 57 Montgomery Road, Fort Montgomery, NY 10922 | 2020-10-29 |
| 1700486560 | Jayanti Rao | Physician Assistant | 1059 Union St Apt 3g, Brooklyn, NY 11225-1268 | 2020-10-29 |
| Find all providers with the same taxonomy | ||||
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| 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.