Individual provider Active NPI

Jessica Lott, FNP-BC

  • Family Nurse Practitioner
  • Austin, TX
National Provider Identifier
1003544453
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1089746 Issued in TX
Practice address
11671 Jollyville Rd Ste 202
Austin, TX 78759-4141
Phone
(512) 343-9848
NPI assigned
Aug 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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 1089746 TX Primary

Addresses

Primary practice location

11671 Jollyville Rd Ste 202
Austin, TX 78759-4141

Mailing address

1508 Avery Elissa LN
Cedar Park, TX 78613-1424
Phone (361) 249-0601

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
I20241111003329 TX Practitioner - Nurse Practitioner 1254865462 Reassigns benefits to 2 organizations

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
Indiemd TX Management LLCGroup PAC ID 3678928462, 20 clinicians

Practice addresses (Care Compare)

7000 N Mopac Expy
Suite 305
Austin, TX 78731-3261
Phone (877) 988-7420

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1089746TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indiemd TX Management LLC CurrentSince Dec 4, 2024 Accepting new patients
Indiemd Network LLC CurrentSince Oct 29, 2024 Accepting new patients
Dose Management PA Family PastSince Aug 14, 2022 Accepting new patients
West Coast Wound and Skin Care Inc Past Accepting new patients

Locations

7000 N Mopac Expy
Ste 305
Austin, TX 78731
Phone (877) 988-7420

309 Water St
Ste 108
Boerne, TX 78006
Phone (877) 988-7420

309 Water St
Ste 107
Boerne, TX 78006
Phone (469) 682-5827

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1003544453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 AVERY ELISSA LN",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786131424",
            "telephone_number": "361-249-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11671 JOLLYVILLE RD STE 202",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594141",
            "telephone_number": "512-343-9848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOTT",
        "first_name": "JESSICA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1089746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.