Individual provider Active NPI

Jessica Lord, MS, PA-C

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1083299564
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA13524 Issued in TX
Practice address
6410 Fannin St Ste 425
Houston, TX 77030-3005
Phone
(713) 486-6755
NPI assigned
Mar 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA13524 TX Primary

Addresses

Primary practice location

6410 Fannin St Ste 425
Houston, TX 77030-3005

Mailing address

6410 Fannin St Ste 425
Houston, TX 77030-3005

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
I20210518001329 TX Practitioner - Physician Assistant 5496164782 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA13524TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Physician Assistant CurrentSince May 10, 2021 Accepting new patients
Ut Physicians CurrentSince May 10, 2021 Accepting new patients

Locations

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6410 Fannin St
Ste 425
Houston, TX 77030
Phone (713) 500-5737

6410 Fannin St
#6264
Houston, TX 77030

6411 Fannin St
#I400
Houston, TX 77030

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.

NPI Registry JSON

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1083299564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST STE 425",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST STE 425",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303005",
            "telephone_number": "713-486-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORD",
        "first_name": "JESSICA",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-16",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA13524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.