Individual provider Active NPI

Kelly R Lawler, DPM

  • Podiatrist
  • Irving, TX
National Provider Identifier
1417068909
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
2042 Issued in TX
Practice address
2021 N Macarthur Blvd Ste 300
Irving, TX 75061-2223
Phone
(972) 817-1270
Fax
(972) 817-1275
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 2042 TX Primary

Addresses

Primary practice location

2021 N Macarthur Blvd Ste 300
Irving, TX 75061-2223

Mailing address

9099 Christopher St
Lantana, TX 76226-6492

Other identifiers 1

IdentifierTypeStateIssuer
016005246MedicaidIL

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140606000245 TX Practitioner - Podiatry 9133154313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

1901 N Macarthur Blvd
Irving, TX 75061-2220
Phone (972) 579-8485

2021 N Macarthur Boulevard
Irving, TX 75061-2210

2021 N Macarthur Boulevard
300 Baylor Scott and White Medical and Surg
Irving, TX 75061-2223
Phone (972) 817-1270

4001 Worth St
Dallas, TX 75246-1608

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2042TXMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jul 18, 2022 Accepting new patients
Healthtexas Provider Network CurrentSince Jul 18, 2022 Accepting new patients

Locations

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

2021 N MacArthur Blvd
Ste 300
Irving, TX 75061
Phone (972) 254-3118

Interoperability endpoints

  • Direct secure messaging: klawler457981@direct.sw.org

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.

Hospital & facility affiliations 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1417068909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9099 CHRISTOPHER ST",
            "city": "LANTANA",
            "state": "TX",
            "postal_code": "762266492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 N MACARTHUR BLVD STE 300",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750612223",
            "telephone_number": "972-817-1270",
            "fax_number": "972-817-1275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWLER",
        "first_name": "KELLY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "2042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016005246",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.