Organization Active NPI

Lotus Geriatric Nurse Practitioner Consultants LLC

  • Gerontology Nurse Practitioner
  • Westmont, IL
National Provider Identifier
1295263747
Registry record updated May 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
209008833 Issued in IL
Legal business name
LOTUS GERIATRIC NURSE PRACTITIONER CONSULTANTS LLC
Practice address
5801 S Cass Ave
Westmont, IL 60559-2300
Phone
(630) 971-2645
NPI assigned
May 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2017

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

Authorized official

Name
Mrs. Patricia Ann McCann, APN BCNPI 1588957013
Title
Advanced Practice Nurse
Phone
(708) 373-7929

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LG0600X 209008833 IL Primary

Addresses

Primary practice location

5801 S Cass Ave
Westmont, IL 60559-2300

Mailing address

12851 S Ponderosa Dr
Palos Heights, IL 60463-1931
Phone (708) 373-7929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170620003193 IL Part B Supplier - Clinic/Group Practice 4981972700 Receives reassigned benefits from 5 practitioners
Practice locations: Westmont, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496102400000",
    "number": "1295263747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12851 S PONDEROSA DR",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631931",
            "telephone_number": "708-373-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 S CASS AVE",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605592300",
            "telephone_number": "630-971-2645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOTUS GERIATRIC NURSE PRACTITIONER CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-30",
        "last_updated": "2017-05-30",
        "status": "A",
        "authorized_official_last_name": "MCCANN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADVANCED PRACTICE NURSE",
        "authorized_official_telephone_number": "708-373-7929",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APN BC"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209008833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westmont, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.