Individual provider Active NPI

Landon Bernhardt Lorenz, MD

  • Obstetrics & Gynecology Physician
  • Cleburne, TX
National Provider Identifier
1376684878
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
R3555 Issued in TX
Practice address
201 Walls Dr Ste 503
Cleburne, TX 76033-4006
Phone
(817) 984-9057
NPI assigned
Feb 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 23983 OK
Obstetrics & Gynecology Physician 207V00000X R3555 TX Primary

Addresses

Primary practice location

201 Walls Dr Ste 503
Cleburne, TX 76033-4006

Mailing address

201 Walls Dr Ste 503
Cleburne, TX 76033-4006
Phone (817) 984-9057

Other identifiers 4

IdentifierTypeStateIssuer
1427182682OtherNMGROUP NPI
NM001M59OtherNMBCBS PROVIDER ID
343208MedicaidAZ
MD2008-0332OtherNMNEW MEXICO STATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address llorenz1188250@Direct.TexasHealth.org Health Information Exchange (HIE)

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
I20171226000931 TX Practitioner - Obstetrics/Gynecology 4284709205 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R3555TXMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Nov 1, 2021 Accepting new patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group Obstetrics & Gynecology CurrentSince Nov 1, 2021 Accepting new patients
Alazar Medical Group, PLLC PastSince Oct 1, 2017 Accepting new patients
Texas Health Physicians Group Obstetrics & Gynecology Past Accepting new patients
Texas Health Harris Methodist Hospital Fort Worth Past Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

201 Walls Dr
Ste 505
Cleburne, TX 76033
Phone (817) 556-9700

201 Walls Dr
Ste 503
Cleburne, TX 76033
Phone (817) 645-2122

201 Walls Dr
Cleburne, TX 76033
Phone (817) 556-5587

1300 W Terrell Ave
Ste 300
Fort Worth, TX 76104
Phone (817) 250-7360

Interoperability endpoints

  • Direct secure messaging: llorenz1188250@direct.texashealth.org
  • FHIR API: https://epproxy.texashealth.org/FHIR/api/FHIR/DSTU2/
  • FHIR API: https://fhir4.healow.com/fhir/r4/BAEJCA

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.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1376684878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 WALLS DR STE 503",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760334006",
            "telephone_number": "817-984-9057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 WALLS DR STE 503",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760334006",
            "telephone_number": "817-984-9057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORENZ",
        "first_name": "LANDON",
        "middle_name": "BERNHARDT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "23983",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "R3555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1427182682",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "NM001M59",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "343208",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEXICO STATE LICENSE",
            "identifier": "MD2008-0332",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "llorenz1188250@Direct.TexasHealth.org",
            "affiliation": "N",
            "endpointDescription": "Health Information Exchange",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "201 Walls Dr Ste 503",
            "city": "Cleburne",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760334006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

Verify at the official NPI Registry.