Waco Functional Medicine, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

K3775 Issued in TX

Legal business name

WACO FUNCTIONAL MEDICINE, PA

Practice address

318 Richland West Cir Ste B
Waco, TX 76712-7919

Phone

(254) 776-8009

NPI assigned

Nov 10, 2010

Last updated

Nov 10, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa J Kirk, D.O.NPI 1578562146

Title

Owner

Phone

(254) 776-8009

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa Johnson Kirk, D.O.

  • Family Medicine Physician
  • Waco, TX
  • NPI 1578562146
  Medicare reassignment Care Compare group NPD Authorized official
• Tokamy Lachelle Alejo, MSN,APRN,OCN, FNP-BC

  • Family Nurse Practitioner
  • Waco, TX
  • NPI 1982300703
  Medicare reassignment Care Compare group NPD
• Shelly Jean Culver, F.N.P.

  • Nurse Practitioner
  • Temple, TX
  • NPI 1881827822

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Natalie Nicole Fontenot, FNP-C

  • Family Nurse Practitioner
  • Waco, TX
  • NPI 1508467515
  Medicare reassignment Care Compare group NPD
• Helen J Lim, MD

  • Internal Medicine Physician
  • Arlington, TX
  • NPI 1831208073
  Medicare reassignment Care Compare group NPD
• Laura Michelle Myers, APRN, FNP-C

  • Nurse Practitioner
  • Waco, TX
  • NPI 1780429894
  Medicare reassignment Care Compare group NPD
• Travis Roeder, PA-C

  • Medical Physician Assistant
  • Waco, TX
  • NPI 1396446829
  Medicare reassignment Care Compare group
• Rachel Fahlenkamp Warapius, APRN, FNP-C

  • Family Nurse Practitioner
  • Waco, TX
  • NPI 1356094072

  Multi-Specialty

  Medicare reassignment NPD
• Kayla Renee Davis, PA

  • Medical Physician Assistant
  • Waco, TX
  • NPI 1255689881
  Medicare reassignment
• Shelby Elizabeth Thomas, PA-C

  • Physician Assistant
  • Waco, TX
  • NPI 1699347450
  NPD (past)

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289347200000",
    "number": "1093016826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 RICHLAND WEST CIR STE B",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127919",
            "telephone_number": "254-776-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 RICHLAND WEST CIR STE B",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127919",
            "telephone_number": "254-776-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WACO FUNCTIONAL MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-10",
        "last_updated": "2010-11-10",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-776-8009",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K3775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Waco Center for Women's Health, P.a.
• Waco Dental and Orthodontics, PLLC (Rodeo Dental and Orthodontics)
• Waco Endoscopy Center, LLC
• Waco Eye Associates, PA
• Waco Eye Surgery Center LLC
• Waco Gastroenterology Associates
• Waco Gastroenterology Endoscopy Center LLC (Waco Gastroenterology Endoscopy Center)
• Waco Grins Pediatric Dentistry, PLLC
• Waco Healthcare Residence LLC (Crestview Nursing and Rehab Center)
• Waco Hearing Center PLLC

• Family Medicine Physician in Waco, TX
• Providers in Waco, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.