Lecelt, Inc

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

LECELT, INC

Practice address

2133 Office Park Dr Ste a
San Angelo, TX 76904-6803

Phone

(325) 703-6670

Fax

(325) 703-6672

NPI assigned

May 3, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Jean Lynn Henrikson, FNPNPI 1326009739

Title

Owner

Phone

(325) 703-6670

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Henrikson Primary Care Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

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

• Jean Lynn Henrikson, NP

  • Family Nurse Practitioner
  • San Angelo, TX
  • NPI 1326009739
  Medicare reassignment NPD Authorized official
• Brad Richard Baker, MD

  • Family Medicine Physician
  • San Angelo, TX
  • NPI 1760460422
  Medicare reassignment NPD

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1306372917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3371 KNICKERBOCKER RD",
            "address_2": "# 236",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046814",
            "telephone_number": "325-703-6670",
            "fax_number": "325-703-6672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2133 OFFICE PARK DR STE A",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046803",
            "telephone_number": "325-703-6670",
            "fax_number": "325-703-6672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LECELT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-03",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "HENRIKSON",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "325-703-6670",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164744807",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henrikson Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Henrikson Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anne Blake Stevens Lauer, PT
• Sarah Jo Laurent, BEHAVORIAL TECH
• Kassidi Leigh Lawson
• Kyle J Lawson, DC, MS, CFMP
• Kori Hester Leach, LVN
• Skylar Lee
• Tipton B Lee, DDS
• Kristene Amanda Leek, FNP-C
• Legend Oaks - San Angelo, LLC
• Robert H Legrand, MD

• Family Nurse Practitioner in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.