Individual provider Active NPI

Renee Naomi Livesay, FNP

  • Family Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1003520230
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
600525 Issued in TX
Practice address
8504 Kenosha Dr
Lubbock, TX 79423-2727
Phone
(806) 773-5880
NPI assigned
Jan 11, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 600525 TX Primary

Addresses

Primary practice location

8504 Kenosha Dr
Lubbock, TX 79423-2727

Mailing address

8504 Kenosha Dr
Lubbock, TX 79423-2727
Phone (806) 773-5880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231016000144 TX Practitioner - Nurse Practitioner 1456706266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical GroupGroup PAC ID 6901889393, 228 clinicians

Practice addresses (Care Compare)

3612 23Rd St
Lubbock, TX 79410-1326
Phone (806) 793-8787

Hospital & facility affiliations

  • Grace Surgical Hospital Hospital, Lubbock, TX, CCN 450162
  • Covenant Medical Center Hospital, Lubbock, TX, CCN 450040
  • Covenant Hospital Plainview Hospital, Plainview, TX, CCN 450539
  • Covenant Childrens Hospital Hospital, Lubbock, TX, CCN 453306
  • Nor-Lea Hospital District Hospital, Lovington, NM, CCN 321305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
600525TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group CurrentSince Jul 1, 2023 Accepting new patients
Covenant Medical Group CurrentSince Jul 1, 2023 Accepting new patients

Locations

2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228

3612 23rd St
Lubbock, TX 79410
Phone (806) 725-8787

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1003520230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8504 KENOSHA DR",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794232727",
            "telephone_number": "806-773-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8504 KENOSHA DR",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794232727",
            "telephone_number": "806-773-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVESAY",
        "first_name": "RENEE",
        "middle_name": "NAOMI",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-11",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "600525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.