DR. LISA MARIE WANNAMAKER (D.O.) – Family Medicine Physician, NPI 1912069451
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. LISA MARIE WANNAMAKER (D.O.)
4446 Washington Rd Ste 7
Evans, GA 308096361
Phone: (706) 650-3173
Fax: (706) 863-5233
Type: Location
925 Branch Ct
Grovetown, GA 308133325
Phone: (706) 396-3570
Fax: (706) 396-3590
Type: Location
447 N Belair Rd
Evans, GA 308093090
Phone: (706) 854-2180
Fax: (706) 854-2189
Type: Location
465 N Belair Rd Ste 2B
Evans, GA 308093190
Phone: (706) 774-7400
Fax: (706) 774-7590
Type: Location
3486 Peach Orchard Rd Ste 100
Augusta, GA 309065215
Phone: (706) 828-8000
Fax: (706) 828-8001
Type: Location
Lombardia, Via Pianezza, Villaggio Santa Caterina, Circoscrizione 5, Turin, Torino, Piemont, 10151, Italy
AUGUSTA, GA 309031705
Phone: (706) 774-7263
Fax: (706) 774-7230
Type: Mailing
Washington Road, Country Place, Columbia County, Georgia, 30802, United States
EVANS, GA 30809
Phone: (706) 774-7263
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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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: 2017-08-30
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170830001915 | I | Internal Medicine | GA | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30809)
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