Individual provider Active NPI

Lori M Looka, PNP

  • Pediatric Nurse Practitioner
  • San Angelo, TX
National Provider Identifier
1336114867
Registry record updated Jan 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
551502 Issued in TX
Practice address
120 E Beauregard Ave
San Angelo, TX 76903-5919
Phone
(325) 658-1511
NPI assigned
Feb 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 551502 TX Primary

Addresses

Primary practice location

120 E Beauregard Ave
San Angelo, TX 76903-5919

Mailing address

PO Box 22000
San Angelo, TX 76902-7200
Phone (325) 658-1511

Other identifiers 1

IdentifierTypeStateIssuer
134776203MedicaidTX

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
I20100119000581 TX Practitioner - Nurse Practitioner 8325180219 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
551502TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Clinic CurrentSince Nov 18, 2009 Accepting new patients
Midland County Hospital District Past Accepting new patients

Locations

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

225 E Beauregard Ave
San Angelo, TX 76903
Phone (325) 245-4301

Interoperability endpoints

  • Direct secure messaging: llooka6862@shannonhealth.direct-ci.com

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": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359072000000",
    "number": "1336114867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22000",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769027200",
            "telephone_number": "325-658-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E BEAUREGARD AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035919",
            "telephone_number": "325-658-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOOKA",
        "first_name": "LORI",
        "middle_name": "M",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-20",
        "last_updated": "2013-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "551502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134776203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.