Individual provider Active NPI

Lissa Flory McDonald, AG-ACNP BC

  • Acute Care Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1265030787
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1010313 Issued in TX
Practice address
3506 21St St Ste 400
Lubbock, TX 79410-1200
Phone
(806) 725-4115
NPI assigned
Oct 16, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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 1010313 TX
Acute Care Nurse Practitioner 363LA2100X 1010313 TX Primary

Addresses

Primary practice location

3506 21St St Ste 400
Lubbock, TX 79410-1200

Mailing address

4679 Dreibrodt Rd
San Marcos, TX 78666-3388
Phone (915) 261-3892

Other practice location 1

4679 Dreibrodt Rd
San Marcos, TX 78666-3388
Phone (915) 261-3892

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
I20220510001195 TX Practitioner - Nurse Practitioner 8325425580 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2215 Nashville Ave
Lubbock, TX 79410-1105

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Texas, PLLC Nurse Practitioner CurrentSince Apr 1, 2022 Accepting new patients
Cogent Healthcare of Texas, PA Nurse Practitioner CurrentSince Apr 1, 2022 Accepting new patients

Locations

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

3615 19th St
Lubbock, TX 79410
Phone (806) 725-0000

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

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": "1602806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1265030787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4679 DREIBRODT RD",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786663388",
            "telephone_number": "915-261-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3506 21ST ST STE 400",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101200",
            "telephone_number": "806-725-4115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4679 Dreibrodt Rd",
            "address_purpose": "LOCATION",
            "city": "San Marcos",
            "state": "TX",
            "postal_code": "786663388",
            "country_code": "US",
            "telephone_number": "915-261-3892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLORY MCDONALD",
        "first_name": "LISSA",
        "credential": "AG-ACNP BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-16",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1010313",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1010313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.