LISA DIANE WITHERSPOON (FNP) – Family Nurse Practitioner, NPI 1992014450

LISA DIANE WITHERSPOON (FNP) is a healthcare provider. based in San antonio, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 309008440 (IL). The NPI Number for LISA DIANE WITHERSPOON (FNP) is 1992014450

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
LISA DIANE WITHERSPOON (FNP)
NPI
1992014450
Phone
(210) 358-2078
Address
4502 MEDICAL DR
Enumeration Date
1 October 2010
Last Update Date
22 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2107674000
Graduation Year
2006 (20 years ago)
PAC ID
8123291473
Group Practice PAC ID
3870860935
Professional Enrollment ID
I20160512001077
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness85
Years active:15State licenses:3Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for LISA DIANE WITHERSPOON (FNP)

  • 4502 MEDICAL DR

    SAN ANTONIO, TX 782294402

    Phone: (210) 358-2078

    Fax: (210) 702-6274

    Type: Mailing

  • 188 EDGEWATER DR

    CRYSTAL LAKE, IL 600145173

    Phone: (903) 355-0363

    Type: Mailing

  • 600 HART RD STE 310

    BARRINGTON, IL 600102603

    Phone: (847) 304-0044

    Type: Location

  • 325 N SAINT PAUL ST STE 3100

    DALLAS, TX 752013923

    Phone:

    Fax: (888) 731-8994

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-05-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160512001077INurse PractitionerTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99284Emergency department visit with moderate level of medical decision making1515$0
View full utilization report →

Insurance plans in this area (ZIP 78229)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What is the registry number for LISA DIANE WITHERSPOON (FNP)?
The registry entry for LISA DIANE WITHERSPOON (FNP) shows NPI 1992014450.
Should I treat LISA DIANE WITHERSPOON (FNP) as an active provider?
Patients and plans typically see LISA DIANE WITHERSPOON (FNP) as active in the national extract.
What services align with LISA DIANE WITHERSPOON (FNP)'s listing?
LISA DIANE WITHERSPOON (FNP)'s public classification highlights Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to LISA DIANE WITHERSPOON (FNP)?
The directory associates LISA DIANE WITHERSPOON (FNP) with San Antonio, Texas. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.