Individual provider Active NPI

Lesley Sara John, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Allen, TX
National Provider Identifier
1396363107
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1002469 Issued in TX
Practice address
1772 W McDermott Dr
Allen, TX 75013-3342
Phone
(469) 340-2777
NPI assigned
Jul 8, 2020
Last updated
Apr 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1002469 TX Primary

Addresses

Primary practice location

1772 W McDermott Dr
Allen, TX 75013-3342

Mailing address

1772 W McDermott Dr
Allen, TX 75013-3342
Phone (469) 340-2777

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
I20210202000485 TX Practitioner - Nurse Practitioner 7315351426 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shahla Ali MD PAGroup PAC ID 4587971452, 25 clinicians

Practice addresses (Care Compare)

1774 W McDermott Dr
Suite 150
Allen, TX 75013-3424
Phone (469) 340-2777

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Mental Health & Mental Retardation Center CurrentSince Oct 15, 2020 Accepting new patients
Shahla Ali MD PA CurrentSince Apr 20, 2021 Accepting new patients
Shahla Ali MD PA CurrentSince Apr 8, 2021 Accepting new patients

Locations

1774 W McDermott Dr
Ste 150
Allen, TX 75013
Phone (469) 340-2777

1345 River Bend Dr
Ste 200
Dallas, TX 75247
Phone (469) 899-3200

9708 Skillman St
Dallas, TX 75243
Phone (214) 221-5433

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1396363107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1772 W MCDERMOTT DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133342",
            "telephone_number": "469-340-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1772 W MCDERMOTT DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133342",
            "telephone_number": "469-340-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "LESLEY",
        "middle_name": "SARA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1002469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

Verify at the official NPI Registry.