Individual provider Active NPI

Stephanie L Lawrence, PA

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1417974007
Registry record updated Mar 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03195 Issued in TX
Practice address
1250 8TH Ave
Suite 435
Fort Worth, TX 76104-4124
Phone
(817) 923-0088
Fax
(817) 924-5144
NPI assigned
Jul 17, 2006
Last updated
Mar 29, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2013

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 PA03195 TX Primary

Addresses

Primary practice location

1250 8TH Ave
Suite 435
Fort Worth, TX 76104-4124

Mailing address

PO Box 961205
Fort Worth, TX 76161-1205
Phone (817) 740-8400

Other identifiers 2

IdentifierTypeStateIssuer
970030568OtherRAILROAD MEDICARE
181583905MedicaidTX

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
I20060314000229 TX Practitioner - Physician Assistant 4880601004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

400 W Magnolia Ave
Fort Worth, TX 76104-7617
Phone (817) 288-9800

5303 Harry Hines Blvd
Dallas, TX 75390-7208

5323 Harry Hines Blvd
Dallas, TX 75390-7208
Phone (214) 645-8200

5939 Harry Hines Blvd
Dallas, TX 75235-6246

600 S Main St
Fort Worth, TX 76104-2410

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA03195TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince May 11, 2015 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince May 11, 2015 Accepting new patients
Texas Health Care, P.L.L.C. Past Accepting new patients
Texas Health Care, P.L.L.C. Past Accepting new patients

Locations

600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: slawrence106593@direct.swmed.us

Organizations & group practices 5

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.

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364515200000",
    "number": "1417974007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 961205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761611205",
            "telephone_number": "817-740-8400",
            "fax_number": "817-924-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 8TH AVE",
            "address_2": "SUITE 435",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044124",
            "telephone_number": "817-923-0088",
            "fax_number": "817-924-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "STEPHANIE",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2013-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970030568",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181583905",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.