Active NPI
Lori Grisham, MT
- Laboratory Management Specialist/Technologist
- Lewisville, TX
National Provider Identifier
1528443298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Laboratory Management Specialist/Technologist
- License
- 69721
- Practice address
- 751 Hebron Pkwy
Suite 110
Lewisville, TX 75057-5055 - Phone
- (940) 453-1597
- NPI assigned
- Jul 23, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Laboratory Management Specialist/Technologist | 246QL0900X | 69721 | OK | Primary |
Addresses
Primary practice location
751 Hebron Pkwy
Suite 110
Lewisville, TX 75057-5055
Mailing address
109 Oakwood LN
Hickory Creek, TX 75065-7673
Phone (940) 453-1597
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69721 | OK | MD | Laboratory Management Specialist/Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437609600000",
"number": "1528443298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 OAKWOOD LN",
"city": "HICKORY CREEK",
"state": "TX",
"postal_code": "750657673",
"telephone_number": "940-453-1597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "751 HEBRON PKWY",
"address_2": "SUITE 110",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750575055",
"telephone_number": "940-453-1597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRISHAM",
"first_name": "LORI",
"name_prefix": "Mrs.",
"credential": "MT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-23",
"last_updated": "2015-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "246QL0900X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Laboratory Management",
"state": "OK",
"license": "69721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewisville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.