Lisa M York (NPI# 1295730778, PAC ID# 1456328400) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1295730778 |
| PAC ID by PECOS | 1456328400 |
| Professional Enrollment ID | I20040910000609 |
| Full Name | Lisa M York |
| Organization Legal Name | SOUTHERN DOMINION HEALTH SYSTEM, INC. |
| Address |
1508 K V Rd Victoria VA 23974-2624 |
| Phone Number | 4346962165 |
| Gender | F |
| Credential | MD |
| Medical School | UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE |
| Graduation Year | 2001 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 0648188755 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490098 | COMMUNITY MEMORIAL HOSPITAL |
| 490090 | CENTRA SOUTHSIDE COMMUNITY HOSPITAL, INC |
| 490136 | BON SECOURS ST FRANCIS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1508 K V Rd, Victoria, VA 23974-2624 | 4346962165 | SOUTHERN DOMINION HEALTH SYSTEM, INC. |
| Organization Legal Name | SOUTHERN DOMINION HEALTH SYSTEM, INC. |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda L Russell | Family Medicine | Southern Dominion Health System, Inc. | 13855 Courthouse Rd, Dinwiddie, VA 23841-2254 |
| Margaret K Inge | Family Medicine | Southern Dominion Health System, Inc. | 8920 Otterburn Rd, Amelia Court House, VA 23002-4854 |
| Margaret R Campbell | Pediatric Medicine | Southern Dominion Health System, Inc. | 8920 Otterburn Rd, Amelia Court House, VA 23002-4854 |
| Fitzgerald Marcelin | Internal Medicine | Southern Dominion Health System, Inc. | 13855 Courthouse Rd, Dinwiddie, VA 23841-2254 |
| Shannon L Rakes | Clinical Social Worker | Southern Dominion Health System, Inc. | 1508 K V Rd, Victoria, VA 23974-2624 |
| Hyo Kwon Park | Family Medicine | Southern Dominion Health System, Inc. | 13855 Courthouse Rd, Dinwiddie, VA 23841-2254 |
| John A Holland | Family Medicine | Southern Dominion Health System, Inc. | 1508 K V Rd, Victoria, VA 23974-2624 |
| Debra M Sequeira | Family Medicine | Southern Dominion Health System, Inc. | 8920 Otterburn Rd, Amelia Court House, VA 23002-4854 |
| Street Address |
1508 K V RD |
| City | VICTORIA |
| State | VA |
| Zip | 23974-2624 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shannon L Rakes | Clinical Social Worker | Southern Dominion Health System, Inc. | 1508 K V Rd, Victoria, VA 23974-2624 |
| John A Holland | Family Medicine | Southern Dominion Health System, Inc. | 1508 K V Rd, Victoria, VA 23974-2624 |
| City | VICTORIA |
| Zip Code | 23974 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | VICTORIA + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Lisa M York.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.