Individual provider Active NPI

Lucille Kathryn McLean, APRN

  • Family Nurse Practitioner
  • Keller, TX
National Provider Identifier
1548091945
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1170905 Issued in TX
Practice address
808 Keller Pkwy
Keller, TX 76248-2405
Phone
(817) 431-2573
NPI assigned
Aug 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1170905 TX Primary

Addresses

Primary practice location

808 Keller Pkwy
Keller, TX 76248-2405

Mailing address

808 Keller Pkwy
Keller, TX 76248-2405
Phone (817) 431-2573

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
I20240823001333 TX Practitioner - Nurse Practitioner 4789123639 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1170905TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bill Burke, DO a Professional Association Family Medicine CurrentSince Aug 8, 2024 Accepting new patients
Keller Family Medical Center, PLLC Family Medicine CurrentSince Aug 8, 2024 Accepting new patients

Locations

808 Keller Pkwy
Keller, TX 76248
Phone (817) 431-2573

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/28296/brand/1/csg/1/fhir/r4
  • Direct secure messaging: lucille.mclean.1@28296.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1548091945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 KELLER PKWY",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482405",
            "telephone_number": "817-431-2573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 KELLER PKWY",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482405",
            "telephone_number": "817-431-2573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEAN",
        "first_name": "LUCILLE",
        "middle_name": "KATHRYN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1170905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

Verify at the official NPI Registry.