Individual provider Active NPI

Lori Wasson, D.O.

  • Anatomic Pathology & Clinical Pathology Physician
  • Fort Worth, TX
National Provider Identifier
1336146786
Registry record updated Jun 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
H8497 Issued in TX
Practice address
1401 Pennsylvania Ave
Fort Worth, TX 76104-2113
Phone
(713) 432-1100
Fax
(713) 432-0221
NPI assigned
Jun 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X H8497 TX Primary

Addresses

Primary practice location

1401 Pennsylvania Ave
Fort Worth, TX 76104-2113

Mailing address

14275 Midway Rd
Suite 400
Addison, TX 75001-3614
Phone (214) 932-8029

Other identifiers 4

IdentifierTypeStateIssuer
121877803MedicaidTX
8B0320OtherTXBLUE CROSS BLUE SHIELD
116816304MedicaidTX
220030725OtherTXRR MEDICARE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101102000448 TX Practitioner - Pathology 4880733849 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of North Texas HSC, College of Osteopathic Med, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1401 Pennsylvania Ave
Fort Worth, TX 76104-2113
Phone (817) 250-5630

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Ameripath Lubbock 5.01(a) Corporation Anatomic Pathology & Clinical Pathology CurrentSince Oct 31, 2019 Accepting new patients
DFW 501a Corporation Anatomic Pathology & Clinical Pathology CurrentSince Jul 15, 2010 Accepting new patients
Ameripath Lubbock 501a Corporation Anatomic Pathology & Clinical Pathology Current Accepting new patients
DFW 501a Corporation Anatomic Pathology & Clinical Pathology Current Accepting new patients
DFW 501a Corporation Anatomic Pathology & Clinical Pathology CurrentSince Jul 15, 2010 Accepting new patients
Ameripath Lubbock 501a Corporation Past Accepting new patients

Locations

14275 Midway Rd
Ste 400
Addison, TX 75001
Phone (214) 932-8018

108 Denver Trl
Azle, TX 76020
Phone (817) 444-8600

10864 Texas Health Trl
Fort Worth, TX 76244
Phone (682) 212-2000

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

1401 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-5630

2118 Broadway
Lubbock, TX 79401
Phone (806) 785-7903

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

4401 Booth Calloway Rd
Richland Hls, TX 76180
Phone (817) 255-1000

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435276800000",
    "number": "1336146786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD",
            "address_2": "SUITE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013614",
            "telephone_number": "214-932-8029",
            "fax_number": "610-271-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042113",
            "telephone_number": "713-432-1100",
            "fax_number": "713-432-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSON",
        "first_name": "LORI",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2015-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "H8497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121877803",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8B0320",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116816304",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "220030725",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.