Individual provider Active NPI

Lesley C Murchison, MD

  • Pediatrics Physician
  • Fort Worth, TX
National Provider Identifier
1225119126
Registry record updated May 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
H0667 Issued in TX
Practice address
1300 W Lancaster Ave
Ste 101
Fort Worth, TX 76102-3410
Phone
(817) 870-2910
Fax
(817) 870-2180
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X H0667 TX Primary

Addresses

Primary practice location

1300 W Lancaster Ave
Ste 101
Fort Worth, TX 76102-3410

Mailing address

PO Box 99371
Fort Worth, TX 76199-0371
Phone (682) 885-1855

Other identifiers 13

IdentifierTypeStateIssuer
1750369203OtherGRP NPI NUMBER
1392580OtherTXUHC PIN
4140237OtherTXAETNA PIN
87043GOtherTXBCBSTX IND PIN
00U87ZOtherTXBCBSTX GRP PIN
127166008MedicaidTX
137345801MedicaidTX
177056201MedicaidTX
120049100OtherTXFIRSTCARE PIN
127166007MedicaidTX
4340938OtherTXCIGNA PIN
MURLB25033OtherTXCCHIP PIN
46864OtherTXFIRSTHEALTH PIN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051121000223 TX Practitioner - Pediatric Medicine 2567481401 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network Pediatrics CurrentSince Dec 31, 2009 Accepting new patients
Cook Children'S Physician Network Pediatrics CurrentSince Dec 31, 2009 Accepting new patients
Cook Children'S Medical Center Past Accepting new patients

Locations

1300 W Lancaster Ave
Ste 101
Fort Worth, TX 76102
Phone (817) 336-8611

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Organizations & group practices 3

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273622400000",
    "number": "1225119126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99371",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990371",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W LANCASTER AVE",
            "address_2": "STE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761023410",
            "telephone_number": "817-870-2910",
            "fax_number": "817-870-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURCHISON",
        "first_name": "LESLEY",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2010-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "H0667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP NPI NUMBER",
            "identifier": "1750369203",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC PIN",
            "identifier": "1392580",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "4140237",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX IND PIN",
            "identifier": "87043G",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX GRP PIN",
            "identifier": "00U87Z",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127166008",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137345801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177056201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE PIN",
            "identifier": "120049100",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127166007",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN",
            "identifier": "4340938",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCHIP PIN",
            "identifier": "MURLB25033",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTHEALTH PIN",
            "identifier": "46864",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.