Individual provider Active NPI

Lisha Thomas

  • Family Nurse Practitioner
  • League City, TX
National Provider Identifier
1174117105
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1030531 Issued in TX
Practice address
2660 Gulf Freeway South
League City, TX 77557
Phone
(832) 505-2150
Fax
(281) 337-0704
NPI assigned
Feb 20, 2021
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1030531 TX
Family Nurse Practitioner 363LF0000X 1030531 TX Primary

Addresses

Primary practice location

2660 Gulf Freeway South
League City, TX 77557

Mailing address

2660 Gulf Freeway South
League City, TX 77573-1486
Phone (832) 505-2150

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
I20210423000911 TX Practitioner - Nurse Practitioner 1850709221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

2660 Gulf Fwy S
Suite 2
League City, TX 77573-6820
Phone (832) 505-2150

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1030531TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice CurrentSince Jun 1, 2024 Accepting new patients

Locations

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

2660 Gulf Fwy S
League City, TX 77573
Phone (832) 505-2100

2660 Gulf Fwy S
Ste 2
League City, TX 77573
Phone (832) 505-2150

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1613779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1174117105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 GULF FREEWAY SOUTH",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775731486",
            "telephone_number": "832-505-2150",
            "fax_number": "281-337-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 GULF FREEWAY SOUTH",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "77557",
            "telephone_number": "832-505-2150",
            "fax_number": "281-337-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "LISHA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-20",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1030531",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1030531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in League City, TX

Sources for this page

Verify at the official NPI Registry.