MRS. LISA JO MATHERSON (NPI# 1922213594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922213594 |
| Entity Type | Individual |
| Full Name | MRS. LISA JO MATHERSON |
| Credential | CRNP |
| Practice Address |
2050 Old West Chester Pike Havertown PA 19083-2712 |
| Mailing Address |
271 Green Hollow Rd Glenmoore PA 19343-1509 |
| Practice Telephone | 6104498600 |
| Practice Fax Number | 6104491302 |
| Mailing Telephone | 6109138008 |
| Mailing Fax Number | 6109138007 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
SPOO3533H | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2050 OLD WEST CHESTER PIKE |
| City | HAVERTOWN |
| State | PA |
| Zip Code | 19083-2712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043382146 | Care Institute of Main Line and Haverford, LLC | Skilled Nursing Facility | 2050 Old West Chester Pike, Havertown, PA 19083-2712 | 2006-11-14 |
| 1053848424 | Platinum Health At Westgate LLC | Skilled Nursing Facility | 2050 Old West Chester Pike, Havertown, PA 19083-2712 | 2017-05-17 |
| 1457896532 | Lindsay Iser | Speech-Language Pathologist | 2050 Old West Chester Pike, Havertown, PA 19083-2712 | 2016-12-28 |
| 1760622161 | Phha, LLC | Skilled Nursing Facility | 2050 Old West Chester Pike, Havertown, PA 19083-2712 | 2009-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043835457 | Kelly Anne Clarke | Counselor | American Treatment Network Physician & Associates, 1120 Township Line Road, Havertown, PA 19083 | 2020-06-11 |
| 1588216238 | Angela Wrolstad | Registered Nurse | 614 Darby Road, Havertown, PA 19083 | 2019-07-12 |
| 1639696214 | Osaru Anyumba | Case Manager/Care Coordinator | 311 Lansdowne Road, Havertown, PA 19083 | 2017-08-24 |
| 1346762739 | Luke Francis Mattson | Pharmacist | 60 West Hillcrest Avenue, Havertown, PA 19083 | 2017-07-07 |
| 1124558150 | Clare M Chakey | Counselor | 1631 Ridgeway Road, Haventown, PA 19083 | 2017-06-13 |
| 1205382553 | Silverware Home Care Service LLC | Residential Treatment Facility, Physical Disabilities | 2010 Wester Chester Pike, Suite 448, Havertown, PA 19083 | 2016-08-28 |
| 1275903486 | Megan Keeley Ramaika | Dietitian, Registered | 404 Fairmont Road, Havertown, PA 19083 | 2015-09-30 |
| 1972987246 | Katie Paugh | Occupational Therapist | One North Belfield Avenue, Havertown, PA 19083 | 2015-07-16 |
| 1497140180 | Total Health Home Care Corporation | Nurse's Aide | 2710 West Township Line Rd, Havertown, PA 19083 | 2015-03-31 |
| 1851704084 | Ul Sik Jason Chong | Pharmacist | 700 East Townshipline Road Ste Ll, Havertown, PA 19083 | 2014-06-05 |
| Find all providers in zip 19083 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063873 | Latasha Evans | Nurse Practitioner | 7440 Rogers Ave, Upper Darby, PA 19082-2010 | 2020-11-03 |
| 1386243830 | Kevin Khoa Nguyen | Nurse Practitioner | 6028 Pine Valley Ln, Fairview, PA 16415-3272 | 2020-10-25 |
| 1255938163 | Nicole Pfeiffer | Nurse Practitioner | 1932 Washington Ln, Meadowbrook, PA 19046-1138 | 2020-10-04 |
| 1508471582 | Yanshi Lin | Nurse Practitioner | 1400 Spring Garden St Apt 904, Philadelphia, PA 19130-4411 | 2020-09-15 |
| 1629683115 | Meghan Bonner | Nurse Practitioner | 333 N Oxford Valley Rd Ste 102, Fairless Hills, PA 19030-2626 | 2020-09-10 |
| 1245850270 | Lori Michele Shotts | Nurse Practitioner | 110 Holmes St, Vandergrift, PA 15690-1658 | 2020-04-20 |
| 1669008140 | Tracy Shenk | Nurse Practitioner | 60 Versailles Ct, Reading, PA 19605-7019 | 2020-03-17 |
| 1346889524 | Crystal Parker | Nurse Practitioner | 816 Laurel Rd, Lansdowne, PA 19050-3609 | 2020-01-05 |
| 1821636317 | Mary Mumbi Njogu | Nurse Practitioner | 907 Woodbrook Ln, Philadelphia, PA 19150-3217 | 2019-12-15 |
| 1790336543 | Angela Olarte | Nurse Practitioner | 1627 Chew St Ste 403, Allentown, PA 18102-3648 | 2019-09-24 |
| 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.