Individual provider Active NPI

Lawrence Letellier, MSN,APRN,FNP-C

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1245834597
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP143391 Issued in TX
Practice address
9910 W Loop 1604 N Ste 128
San Antonio, TX 78254-5610
Phone
(210) 455-6253
NPI assigned
Nov 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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 AP143391 TX Primary

Addresses

Primary practice location

9910 W Loop 1604 N Ste 128
San Antonio, TX 78254-5610

Mailing address

1581 Austin Hwy Ste 102
San Antonio, TX 78218-1860
Phone (210) 436-8400

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lletellier@wellpath.us
Direct Messaging Address lawrence@innovativeuc.com

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
I20220304000017 TX Practitioner - Nurse Practitioner 5890189062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VMD Primary Providers South Hill Country Texas, PLLCGroup PAC ID 4284048646, 30 clinicians

Practice addresses (Care Compare)

9055 Katy Fwy
Suite 200
Houston, TX 77024-1629
Phone (346) 980-2701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP143391TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
VMD Primary Providers South Hill Country Texas, PLLC CurrentSince Feb 1, 2022 Accepting new patients
Orthorehab LLC CurrentSince Mar 21, 2021 Accepting new patients
South Texas Nurse Practitioner Services, PLLC Family CurrentSince Mar 21, 2021 Accepting new patients

Locations

9055 Katy Fwy
Ste 200
Houston, TX 77024
Phone (346) 980-2701

9910 W Loop 1604 N
Ste 128
San Antonio, TX 78254
Phone (210) 281-1106

1581 Austin Hwy
Ste 102
San Antonio, TX 78218

6393 Babcock Rd
#102
San Antonio, TX 78240
Phone (726) 200-1725

20800 US Highway 281 N
San Antonio, TX 78258
Phone (210) 497-5473

Interoperability endpoints

  • Direct secure messaging: lawrence.letellier.1@13711.direct.athenahealth.com

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": "1606435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1245834597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1581 AUSTIN HWY STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782181860",
            "telephone_number": "210-436-8400",
            "fax_number": "833-452-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9910 W LOOP 1604 N STE 128",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782545610",
            "telephone_number": "210-455-6253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETELLIER",
        "first_name": "LAWRENCE",
        "credential": "MSN,APRN,FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-27",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP143391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lletellier@wellpath.us",
            "affiliation": "N",
            "endpointDescription": "Work E-mail",
            "address_1": "2001 Rickabaugh Dr",
            "city": "Big Spring",
            "state": "TX",
            "country_code": "US",
            "postal_code": "797207702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lawrence@innovativeuc.com",
            "affiliation": "N",
            "address_1": "9910 W Loop 1604 N Ste 128",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782545610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.