Individual provider Active NPI

Lora Brown Prifte, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1366879694
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
7716 Lake June Rd
Dallas, TX 75217-1650
Phone
(214) 398-8801
NPI assigned
Oct 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX Primary

Addresses

Primary practice location

7716 Lake June Rd
Dallas, TX 75217-1650

Mailing address

7716 Lake June Rd
Dallas, TX 75217-1650
Phone (214) 398-8801

Other practice location 1

734 W Commerce St
Fairfield, TX 75840-1428
Phone (903) 389-2181

Other names 1

  • Lora Kelly Brown Former name

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
I20180918003245 TX Practitioner - Physician Assistant 3971803263 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA CurrentSince Jun 7, 2021 Accepting new patients

Locations

7716 Lake June Rd
Dallas, TX 75217
Phone (214) 398-8801

1401 W Jefferson Blvd
Dallas, TX 75208
Phone (214) 941-9200

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

Organizations & group practices 1

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": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1366879694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7716 LAKE JUNE RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752171650",
            "telephone_number": "214-398-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7716 LAKE JUNE RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752171650",
            "telephone_number": "214-398-8801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "734 W Commerce St",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "TX",
            "postal_code": "758401428",
            "country_code": "US",
            "telephone_number": "903-389-2181",
            "fax_number": "903-389-0901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRIFTE",
        "first_name": "LORA",
        "middle_name": "BROWN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORA",
            "last_name": "BROWN",
            "middle_name": "KELLY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.