Individual provider Active NPI

Lelia Lagrasse Nichols, NP

  • Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1164658142
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP117988 Issued in TX
Practice address
9201 N Central Expy Ste 210
Dallas, TX 75231-6033
Phone
(214) 265-1818
Fax
(214) 265-1806
NPI assigned
Jun 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP117988 TX Primary

Addresses

Primary practice location

9201 N Central Expy Ste 210
Dallas, TX 75231-6033

Mailing address

9201 N Central Expy Ste 210
Dallas, TX 75231-3500
Phone (214) 265-1818

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
I20090728000287 TX Practitioner - Nurse Practitioner 5991858664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mindful Dermatology PLLCGroup PAC ID 1153685508, 4 clinicians

Practice addresses (Care Compare)

9201 N Central Expy
Suite 210
Dallas, TX 75231-6033
Phone (214) 265-1818

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Dermatology, PLLC CurrentSince Aug 2, 2022 Accepting new patients
Physicians and Allied Health Professionals Group, PA Nurse Practitioner Past Accepting new patients

Locations

9201 N Central Expy
Ste 210
Dallas, TX 75231
Phone (214) 265-1818

9101 N Central Expy
Ste 160
Dallas, TX 75231
Phone (214) 265-1818

Interoperability endpoints

  • Direct secure messaging: leila.nichols@ppoa.directbygreenway.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1164658142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 N CENTRAL EXPY STE 210",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752313500",
            "telephone_number": "214-265-1818",
            "fax_number": "214-265-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 N CENTRAL EXPY STE 210",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752316033",
            "telephone_number": "214-265-1818",
            "fax_number": "214-265-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "LELIA",
        "middle_name": "LAGRASSE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-04",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP117988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.