Individual provider Active NPI

Lillian Oandah, FNP

  • Family Nurse Practitioner
  • Mesquite, TX
National Provider Identifier
1144642638
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
775037 Issued in TX
Practice address
3600 Gus Thomasson Rd Ste 117
Mesquite, TX 75150-6729
Phone
(612) 201-5149
NPI assigned
Jan 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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 775037 TX Primary

Addresses

Primary practice location

3600 Gus Thomasson Rd Ste 117
Mesquite, TX 75150-6729

Mailing address

3600 Gus Thomasson Rd Ste 117
Mesquite, TX 75150-6729
Phone (612) 201-5140

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
I20150330001430 TX Practitioner - Nurse Practitioner 5799002861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3600 Gus Thomasson Rd
Suite 117
Mesquite, TX 75150-6729
Phone (972) 433-0604

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
775037TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Triple Crown Care Family CurrentSince Feb 10, 2022 Accepting new patients
Autistic Treatment Center, Inc. Past Accepting new patients

Locations

3600 Gus Thomasson Rd
Ste 117
Mesquite, TX 75150
Phone (612) 201-5149

Interoperability endpoints

  • Direct secure messaging: lillian.oandah@tcc-tx.direct.office.nextgen.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1389916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1144642638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 GUS THOMASSON RD STE 117",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506729",
            "telephone_number": "612-201-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 GUS THOMASSON RD STE 117",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506729",
            "telephone_number": "612-201-5149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OANDAH",
        "first_name": "LILLIAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-17",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "775037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.