Active NPI
Lisa Ann Wick
- Registered Nurse
- Burkburnett, TX
National Provider Identifier
1013417658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 769980
- Practice address
- 1207 Parliament St
Burkburnett, TX 76354-3118 - Phone
- (940) 569-2218
- NPI assigned
- Feb 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 769980 | TX | Primary |
Addresses
Primary practice location
1207 Parliament St
Burkburnett, TX 76354-3118
Mailing address
1207 Parliament St
Burkburnett, TX 76354-3118
Phone (940) 569-2218
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 769980 | Other | TX | RN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 769980 | TX | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519084800000",
"number": "1013417658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1207 PARLIAMENT ST",
"city": "BURKBURNETT",
"state": "TX",
"postal_code": "763543118",
"telephone_number": "940-569-2218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1207 PARLIAMENT ST",
"city": "BURKBURNETT",
"state": "TX",
"postal_code": "763543118",
"telephone_number": "940-569-2218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICK",
"first_name": "LISA",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-20",
"last_updated": "2018-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TX",
"license": "769980",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN",
"identifier": "769980",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burkburnett, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.